Tagged with Provider Contracting and Enrollment
The Ohio Controlling Board voted unanimously to continue funding for the state’s Medicaid Program, releasing $264 million in state funding needed to qualify for $638 million in federal matching funds.
Massachusetts Senate leaders have released a comprehensive health care legislation containing a wide range of provisions that, if finalized, would require the state to report the top 50 employers with the highest number of employees who receive coverage through MassHealth as well as require those companies identified to pay a large portion of a $200 million assessment to cover funding shortfalls in the state’s Medicaid program, MassHealth.
CMS has published guidelines detailing requirements as to how Merit-Based Incentive Payment System (MIPS)-eligible clinicians must attest in order to prove they have made a good-faith effort to implement and use EHR technology that supports the timely exchange of healthcare information.
Humana and the Cleveland Clinic have created two $0 premium Medicare Advantage health plans for people with Medicare in Cuyahoga County, intended to improve experience and care by providing affordable access patient-focused expert doctors, nurses and facilities.
Humana and Community Care Physicians (CCP) in New York have signed a value-based agreement that will allow in-network access to Humana’s Medicare Advantage members at CCP facilities.
Delaware’s Department of Health and Social Services (DHSS) has announced the names of the companies selected to operate its Medicaid Managed Care Program (MCO) in 2018
Beginning November 1, UnitedHealthcare (UHC) will require a new online notification/prior authorization process for genetic and molecular lab tests for their Commercial benefit plan members.
Effective December 15, Blue Cross and Blue Shield of Illinois (BCBSIL) will implement edits to validate National Drug Code (NDC)s that are submitted on electronic and paper, professional and institutional Blue Cross Medicare Advantage (PPO) and Blue Cross Medicare Advantage (HMO) claims.
Aetna has released updated clinical, payment and coding policy positions, including correct coding of hospital observation, critical care, admission and discharge services, changes to the assistant surgeon list and the pass-through billing policy.
Two Senate health committee leaders announced their joint plan for a short-term deal on a bipartisan health care deal aimed at stabilizing the individual insurance market by extending cost-sharing subsidy payments to insurers for two years.
Indiana Health Coverage Programs (IHCP) has released their annual update of the ICD-10 diagnosis and procedure codes.
Cigna has posted updates to specific medical and preventive care services policies, including its uniform billing editor, pharmacy and infusion services, and omnibus reimbursement.
CMS has introduced a new MIPS Eligible Measure Applicability process to allow providers who were unable to submit the required number of quality measures the opportunity to earn the maximum score for that reporting category.
CMS has announced that people with Medicare will have more choices and options for their Medicare coverage in 2018. The average monthly premium for a Medicare Advantage plan will decrease and enrollment is projected to reach a new all-time high.
As of October 1, Ohio Department of Medicaid (ODM) has begun implementation of its 340B modifier requirement.
The Medical Imaging and Technology Alliance (MITA) has issued new guidelines for live model ultrasound scanning for educational purposes.
CMS has announced it is offering special enrollment periods for all Medicare beneficiaries and certain individuals seeking health plans offered through the Federal Health Insurance Exchange.
The US Department of Veterans Affairs (VA) has proposed a rule that would preempt state laws restricting the ability of VA healthcare providers to supply telehealth services to veterans across state lines or within states, intended to increase the availability of mental health, specialty care, and general clinical care to veterans, especially in rural areas.
Florida state officials have announced submission of the proposed rates for 2018 ACA plans. According to the announcement, premiums may increase by 44.7% next year for ACA compliant plans.
A medical policy from Blue Cross Blue Shield of Michigan sets the insurer apart as the first commercial payer to issue a positive coverage policy for a new lumbar spinal stenosis treatment.