Tagged with Medicaid Billing
The White House has released its budget proposal for fiscal year (FY) 2018 and presented it to Congress. Totaling at $4.1 trillion, the proposal requests $69 billion in discretionary budget authority and $1,046 billion in mandatory funding to help the Department of Health and Human Services (HHS).
The Senate Finance Committee unanimously passed the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017. The legislation seeks to expand telehealth services to Medicaid populations and has received a favorable score by the Congressional Budget Office.
A new bill has been introduced which seeks to increase Medicaid addiction treatment access by modifying the Medicaid Institutions for Mental Disease law to allow more substance abuse treatment centers to receive Medicaid payments.
The Illinois House has approved Senate Bill 1446 that, if finalized, would require the state to use the regular procurement process and would expand the state’s $9 billion Medicaid managed care program statewide, while reducing the number of contracted health plans.
Indiana is the most recent of the six states that are seeking the addition of a work requirement to Medicaid eligibility waiver request.
New York Medicaid regulators hope the call for increased scrutiny of prescription drugs under new state regulations will encourage drugmakers to offer more rebates to low-income people as well as pass on additional savings to the state when Medicaid drug spending rises.
Texas lawmakers have agreed upon a budget for FY 2018-2019 which includes a $1.9 billion cut to Medicaid spending.
Wisconsin’s state budget committee approved a legislation that would require able-bodied, childless adults to undergo drug screening when applying for Medicaid health benefits.
Wisconsin has announced plans to seek federal approval to implement eligibility and other changes to its Medicaid program. According to the waiver summary, Wisconsin plans to submit an application to amend its Medicaid demonstration that would enable the state to impose monthly premiums for beneficiaries with incomes above 20% of federal poverty level, ranging from $1 to $10 per household based on household income.
Florida House and Senate leaders have agreed to approximately $650 million in cuts to hospital payments through Medicaid. The state plans to cut its share of Medicaid payments by $250 million in the upcoming budget, which reduces federal matching dollars by more than $400 million.
Aetna has announced plans completely withdraw from the ACA insurance exchanges for 2018, citing financial losses as the deciding factor, specifically its individual commercial products lost nearly $700 million between 2014 and 2016 and could lose another $200 million this year.
CMS has released guidance stating that it will no longer require U.S. residents enrolling in exchange plans via a direct enrollment pathway to complete the enrollment process on HealthCare.gov.
CMS issued an Informational Bulletin providing additional clarity on provisions of the final regulation defining home and community-based service (HCBS) settings. The bulletin indicates that that states may take an additional three years to ensure compliance with criteria of a HCBS setting. The agency says this additional time “will be helpful to states to ensure compliance activities are collaborative, transparent and timely.”
CMS has sent over 800,000 letters to clinicians, with notification that they will not be evaluated under the MACRA Merit-based Incentive Payment System (MIPS) in 2017. Federal officials predict only about one-third of clinicians will have to file quality reports this year under the new Medicare payment system.
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.