Tagged with Healthcare Reform
Providers and insurance groups are in favor of CMS’ plans to develop a demonstration project that will test the effects of allowing clinicians to receive credit for financial risk-based arrangements with Medicare Advantage (MA) plans.
The New Jersey Department of Human Services (DHS) last month announced that it has expanded the list of covered health benefits available to align behavioral health coverage for Medicaid Long Term Services and Supports (MLTSS), Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs), and Division of Developmentally Disabled (DDD) MCO members participating in the New Jersey FamilyCare (NJFC) Medicaid managed care program.
Massachusetts Senate leaders have released a comprehensive health care legislation containing a wide range of provisions that, if finalized, would require the state to report the top 50 employers with the highest number of employees who receive coverage through MassHealth as well as require those companies identified to pay a large portion of a $200 million assessment to cover funding shortfalls in the state’s Medicaid program, MassHealth.
CMS has released a new policy intended to allow states the ability to design demonstration projects toward increased access to treatment for opioid use disorder (OUD) and other substance use disorders (SUD).
Massachusetts is seeking federal permission to move adults off Medicaid by curbing access to in-home and long-term care supports and limiting drug coverage.
The Medical Imaging and Technology Alliance (MITA) has issued new guidelines for live model ultrasound scanning for educational purposes.
The US Department of Veterans Affairs (VA) has proposed a rule that would preempt state laws restricting the ability of VA healthcare providers to supply telehealth services to veterans across state lines or within states, intended to increase the availability of mental health, specialty care, and general clinical care to veterans, especially in rural areas.
Florida state officials have announced submission of the proposed rates for 2018 ACA plans. According to the announcement, premiums may increase by 44.7% next year for ACA compliant plans.
Toward the efforts to further prevent fraud and identity theft, MACRA mandated that all Social Security numbers be roved from all Medicare cards by April 2019. CMS will begin mailing new Medicare cards with randomly-assigned and unique identifying number in place of the beneficiary’s Social Security number in April 2018.
In an effort to protecting consumers from surprise medical bills a new state law, effective on September 1st, requires freestanding ER facilities to post notice of which insurance network they are in.
New Jersey has launched a six-week outreach effort aimed at aiding staff, providers, and consumers understand the potential benefits and timeline of the state’s Reorganization Plan 001-2017 which would transfer mental health and addiction functions from the Department of Human Services (DHS) to the Department of Health (DOH).
CMS Waives Provider Screening Requirements in Texas and Louisiana During Hurricane Harvey Recovery Efforts
CMS has announced it will suspend certain Medicare enrollment screening requirements for healthcare providers and suppliers that are assisting with Hurricane Harvey recovery efforts in Texas and Louisiana.
Texas Medicaid has proposed to reduce reimbursement rates by at least 10% for several specialties and services. The newly proposed reimbursement rates would take effect on October 1, impacting such specialties as Ears, Nose, and Throat, Radiation Oncology, Nuclear Medicine, Physician Administered Drugs, Substance Use Disorder Services, Hospital Outpatient Imaging, and Rural Hospital Outpatient Imaging.
The American Health Care Act passed the House of Representatives by 217-213 on May 4.
Gallup-Healthways Well-Being Index poll shows uninsured rate increased to 11.3% in the first quarter of 2017 from a record low of 10.9% in the last half of 2016.
CMS has granted the Pennsylvania Department of Health $10 million in startup funds to set up its new alternative payment model for Medicare in rural hospitals. The model will be tested over seven years, four of which will be partially funded by CMS.
CMS has released 2018 Medicare Advantage and Part D payment rates, announcing a 0.45% average rate increase. According to CMS, the changes made aim at providing benefit flexibility and efficiency which will allow Medicare enrollees to choose the care that best fits their health needs.
The Pennsylvania Patient Safety Authority released an in-depth analysis of health information technology (HIT) related medication errors. The report indicates that 889 medication-error events were reported by health care facilities between January 1 and June 30, 2016, all of which indicated health information technology as a contributing factor.
Two separate studies investigated why consumers respond to high-deductible plans by using less healthcare services, which in turn leads to a decrease in doctor visits and clinical laboratory test orders.
CMS’ newest Medicaid managed care final rule will prevent increases in pass-through payments as well as the addition of new pass-through payments beyond those in place when the pass-through payment transition periods were established.