Tagged with Medicaid Billing

Florida Governor Extends 30-Day Retroactive Medicaid Eligibility

The Governor of Florida has extended legislation reducing retroactive Medicaid eligibility from 90 to 30 days for another year. The bill also mandates the state Agency for Health Care Administration to submit a report to the legislature about the impact of the change on patients and health care providers by January 2020.

Anthem Announces Fee Schedule Changes

Anthem Blue Cross and Blue Shield (Anthem) recently notified members of the upcoming changes to its Anthem Plan Fee Schedules, scheduled to take place July 1.

House Renews Several Medicaid Programs, Including Payment Pilot for Mental Health Clinics

The House passed legislation to renew several Medicaid programs, including an eight state pilot that pays higher reimbursement rates to mental health clinics that offer comprehensive mental health services regardless of ability to pay, offering assistance to patients move out of assisted living facilities, covering costs for individuals whose spouses are in long-term care, and preventing Medicaid fraud.

Supreme Court Rules Against HHS in DSH Payment Case

In a 7-1 decision, the Supreme Court ruled in favor of the nine hospitals that said the Department of Health and Human Services (HHS) violated the Medicare Act when it changed Medicare’s reimbursement adjustment formula for disproportionate share hospitals without providing notice and opportunity to comment.

CMS Finalizes Rule to Update and Modernize PACE

CMS has announced the release of a final rule designed to “update and modernize” the Programs of All-Inclusive Care for the Elderly (PACE) program, based upon best practices in caring for frail and elderly individuals.

CMS Final Rule Blocks States from “Diverting” Provider Medicaid Payments to Third Parties

CMS, in early May, released the Medicaid Provider Reassignment Regulation final rule removing a state’s ability to divert portions of Medicaid provider payments to third parties outside of the scope of what the statute allows. Under the rule, CMS is revoking the authority of states to “divert” certain Medicaid provider payments to a third party to fund other costs on behalf of the provider “for benefits such as health insurance, skills training, and other benefits customary for employees.”

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