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CMS Issues “In Lieu of” Services Guidance to Address Health-Related Social Needs in Medicaid Managed Care

C&M Health Law

On January 4, in its most recent effort to expand federal support for addressing health-related social needs (HRSNs), the Centers for Medicare & Medicaid Services (CMS) issued guidance to clarify an existing option for states to address HRSNs through the use of “in lieu of” services and settings policies in Medicaid managed care.

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Why Elevance Health is “Prescribing” Phones for Members

Jane Sarashon

Elevance Health, the health plan organization comprising XXX plans serving 117 million members, launched a program to channel mobile phones and data plans into the hands of some Medicaid plan enrollees, explained in the organization’s press release on the program.

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The SDOH Reality Check: Coding, Claims and Value-Based Care

HIT Consultant

The newest value-based payment program purposely designed to address SDOH is the ACO Realizing Equity, Access, and Community Health (ACO REACH) model, launched by the Centers for Medicare & Medicaid Services (CMS). In 2021, the CMS Office of Minority Health published data on the use of ICD-10-CM Z codes.

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Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report

CMS.gov

Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report. Director, Medicare-Medicaid Coordination Office, Topic. Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report. Jeremy.Booth@c…. Fri, 11/16/2018 - 18:51. Tim Engelhardt. Innovation models.

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FemTech: Diana Health Secures $34M to Expand Maternity Care Model

HIT Consultant

More than 400 hospitals have closed their L&D units between 2016-2020. The model delivers a tech-enabled, holistic care experience for women and families, deploying integrated care teams of Certified Nurse Midwives, OB/GYNs, mental health and wellness providers. Diana Health is targeting underserved areas in the U.S.

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Better Data Will Serve as the Foundation in Modernizing the Medicaid Program

CMS.gov

Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Administrator, Centers for Medicare & Medicaid Services. Medicaid & CHIP. Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Between 2013 and 2016, Federal spending on Medicaid grew by over $100 billion.

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Managing Healthcare Compliance in Pennsylvania

MedTrainer

Its member hospitals and health systems, dedicated to enhancing health outcomes and offering cost-effective care, deliver comprehensive health services across the care spectrum in Pennsylvania. The Pennsylvania Department of Human Services (DHS) is the state’s Medicaid agency.