Tagged with Healthcare Reform

New York Finalizes Draft Waiver Transition Plan for Individuals with Intellectual and Developmental Disabilities

The New York Office for People with Developmental Disabilities (OPWDD) has finalized its Draft Waiver Transition Plan which lays out their vision for reform of the system serving people with intellectual and developmental disabilities (IDD), “People First Care Coordination.” The Transition Plan describes the development of Care Coordination Organizations, which will provide Health Home Care Management services.

Department of Health and Human Services Announces Future Changes to Provider Reimbursements

The Department of Health and Human Services (HHS) has announced its plans to overhaul the way the federal government reimburses providers. The Department states, in an effort to improve technology and transparency, it will make changes to interoperability, price transparency, and care delivery through Medicare and Medicaid, and remove regulations that hinder private innovation.

NJ – DHS Expands Behavioral Health Benefits Covered Under NJ FamilyCare

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.

MA – Senate Releases Comprehensive Health Care Legislation

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.

VA Issues Proposed Rule to Allow Telemedicine Across State Lines

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.

FL – 44.7% Proposed PPACA Rate Increase for 2018

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.

REMINDER: New Medicare Numbers and Cards Coming April 2018

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.

NJ – State Seeks Input on Reorganization Plan for Mental Health, Addiction Services

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).

TX – Medicaid Proposes Reimbursement Cuts of at least 10% for Several Specialties

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.

AdvantEdge