Tagged with Medicaid Billing
The American Health Care Act passed the House of Representatives by 217-213 on May 4.
CMS has named 32 participants to serve as local support for linking clinical and community services in a five-year pilot program under the Center for Medicare and Medicaid Innovation’s Accountable Health Communities model.
CMS has released the 2017 list of approved qualified registries. Physician practices may utilize these third-party vendors to report individual or group data for the Quality, Advancing Care Information, and Improvement Activities categories of the Merit-Based Incentive Payment System (MIPS) in order to avoid a -4% penalty and potentially earn a small bonus in 2019.
The House Finance Committee has approved budget amendments that include several amendments toward the efforts of fighting the state’s heroin and opioid crisis, funding to reduce the sales tax burden on Medicaid managed care organizations, and approval requirements for Medicaid expansion.
Beginning July 1, CMS will require practitioners that are part of a group practice of ten or more that provides global services in certain states to report post-operative visits.
The Delaware Division of Medicaid & Medical Assistance has issued a Delivery System Transformation request for qualifications in an attempt to solicit approaches for improving the quality and delivery of services in the state’s Medicaid managed care programs.
CMS has issued the final market stabilization rule for insurers in the Affordable Care Act market that includes a shortening the open enrollment period for 2018.
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.
The CHRONIC Care Act of 2017 was reintroduced to Congress this month. The proposed bill targets Medicare payment reform for chronic disease management services and would promote the use of telehealth by eliminating geographic restrictions on telestroke consult services, expand telehealth coverage under MA part B, and give ACOs more flexibility to use telehealth services.
A new study has found that Medicaid expansion led to an 11.7% increase in overall spending on Medicaid, which was accompanied by a 12.2% increase in spending from federal funds. No significant increases were observed regarding spending from state funds from the expansion, nor any significant reductions in spending on education or other programs.
The Florida House opted to back away from a wide-ranging Medicaid bill proposal that sought to require Medicaid beneficiaries to pay monthly premiums.
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 bill hopes to expand existing telehealth services for Medicare patients by improving Medicare reimbursements and encouraging healthcare providers to launch telehealth programs through the DHHS’ Center for Medicare and Medicaid Innovation.
CMS announced that it will extend the deadline for comments on the Request for Information (RFI) seeking input on the design of alternative payment models (APMs) focused on improving the health of children and youth covered by Medicaid and CHIP through April 7.
CMS has issued a final rule which outlines how third party payments are treated when calculating hospital-specific limitation on Medicaid disproportionate share hospital (DSH) payments.
CMS has announced a deadline postponement for certain laboratories to report private payer data for the new laboratory fee schedule. CMS stated the deadline was moved to May 30 due to industry feedback which suggested that many reporting entities would not be able to submit a complete set of applicable information by the initial March 31 deadline.
Florida’s House and Senate budget proposal recommends cuts to the state’s share of Medicaid by $238.6 million drafts. Under the proposed budget, Florida hospitals would see a 7% decrease in the Medicaid reimbursement rate, as well as a decrease in federal matching funds.
The Ohio Department of Medicaid (ODM) and Ohio Department of Mental Health and Addiction Services (OhioMHAS) has announced two major policy and operational updates related to Behavioral Health Redesign. These policy modifications include the expansion of MH Day Treatment service for Qualified Mental Health Specialists (QMHSs) as well as the removal of the limit of 24 hours for Mental Health or SUD Nursing services per patient, per calendar year.
Applicable to the technical component, claims billed with modifier FX to indicate X-ray imaging services were provided using film reduces will be subject to a 20% reduction.
Texas Medicaid requires prior authorization for initial testing of Breast Cancer Gene 1 and 2 (BRCA) as well as prior authorization for genetic testing for colorectal cancer procedure code 81288.