Tagged with Medicaid Billing
The Maine House has sustained the governor’s veto of funding bill to expand Medicaid to additional 70,000 Maine residents.
Illinois has received federal approval for the state’s Medicaid funding model, known as the Hospital Assessment Program, to implement a tax that would help raise funds for hospitals across the state.
The House of Representatives has passed a comprehensive piece of legislation specifically designed to help combat opioid use throughout the United States.
On July 1, the Governor of New Jersey signed the 2019 Fiscal Budget into law. The $37.4 billion budget includes increased funding for the Department of Health as well as the state’s Department of Human Services.
CMS has announced the launch of its Data Element Library (DEL), a new free database designed to support the exchange of electronic health information between providers and facilities.
The Department of Labor (DOL), on June 18, issued a final rule that will expand consumer availability of association health plans (AHPs) as of September 1, 2018.
Beginning in July, UnitedHealthcare (UHC) will make changes to some commercial reimbursement policies, including after hours and weekend care, intraoperative neuromonitoring, and its professional and technical component policy for duplicate or repeat services of global test only.
Effective August 1, Humana will implement changes to the time frame for peer-to-peer review process for its Medicare Advantage (MA) health plans.
A resolution has been introduced in Delaware that seeks to allow the state to look-into potential Medicaid buy-in options.
The New York Assembly has passed the New York Health Act, a legislation seeking the establishment of a universal single payer health plan that would provide comprehensive health coverage.
UnitedHealthcare (UHC) released a policy revision for molecular and genetic tests that have proven efficacy in the diagnosis or treatment of medical conditions.
CMS has released a redesigned version of the Drug Spending Dashboards. The updated interactive online dashboards now include year-over-year information on drug pricing and highlight which manufactures have been increasing their prices.
CMS has issued the Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services (CLFS) Subject to Reasonable Charge Payment, which details the changes in the July 2018 update, including access to data file, pricing information, and new codes.
The New York Department of Health has released an update regarding its Medicaid Electronic Health Records (EHR) Incentive Program which provides financial incentives to eligible professionals (EPs) and hospitals to promote the transition to EHRs.
New Jersey Medicaid has announced changes to the state’s NCPDP D.0/1.2 Payer Sheet, intended to enhance the State’s compliance with the National Council for Prescription Drug Program (NCPDP) D.0 standard.
Anthem Blue Cross Blue Shield of Indiana (BCBSIN) Medicaid has released updates to certain coding and medical policies, including the use of unspecified diagnosis codes and prior authorization prior authorization for elotuzumab.
Florida Medicaid released new and revised policies adopted during the second quarter, including prescribed drug services, Medicaid fair hearings, updated definitions, behavior analysis services, medical foster care, and prescribed pediatric extended care.
The Virginia House of Delegates recently passed a state budget that includes funding for Medicaid expansion and stricter work requirements. If finalized, the state budget legislation would expand Medicaid eligibility to about 400,000 low-income adults.
As part of an ongoing effort to reform the state’s Medicaid program and ensure the purchase of cost–effective, high quality healthcare, and better outcomes for its beneficiaries, New York has reduced the number of eligible breast cancer surgery facilities for Medicaid recipients.
Humana has released several claims processing edits, including updates to Outpatient Prospective Payment System (OPPS), Modifiers 96 and 97, HCPCS Drugs & Biologicals, and other policies.