Tagged with Medicaid Billing

FY 2018 Budget Released

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).

Senate Finance Committee Approves Chronic Care Bill

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.

IL – House Approves Bill to Update Managed Care Procurement Process

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.

NY – New Rule Targets Prescription Drug Costs

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.

WI – State Seeks CMS’ Permission to Implement Medicaid Eligibility Limit

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.

FL – State Legislators Approve $83B Budget

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 to Exit all ACA Insurance Marketplaces in 2018

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.

Transition Period Extended for Compliance with HCBS Criteria

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 gives over 800K Physicians Reprieve from MACRA Reporting in 2017

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.

CMS Releases Approved 2017 MIPS Registry List

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.

OH – House Approves 325 Budget Amendments

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.