California revises Medicaid contract awards, adding 2 insurers
Healthcare Dive
JANUARY 4, 2023
Five insurers will now receive lucrative contracts to provide managed care services, starting in 2024, in the country's largest Medicaid market.
This site uses cookies to improve your experience. By viewing our content, you are accepting the use of cookies. To help us insure we adhere to various privacy regulations, please select your country/region of residence. If you do not select a country we will assume you are from the United States. View our privacy policy and terms of use.
Healthcare Dive
JANUARY 4, 2023
Five insurers will now receive lucrative contracts to provide managed care services, starting in 2024, in the country's largest Medicaid market.
Healthcare Dive
JULY 28, 2023
The payer lost 262,700 Medicaid members in the second quarter, dropping its total Medicaid lives to just over 16 million.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Healthcare Dive
APRIL 25, 2024
Despite business growth in the first quarter, Molina reiterated its prior 2024 guidance out of caution that it won’t be able to reprocure the contested contracts.
Fierce Healthcare
NOVEMBER 14, 2023
Medicaid enrollment is projected to slide further next year, according to an annual budget survey of Medicaid officials conducted by KFF and Health Management Associates in collaboration with the N | State Medicaid directors once again see redeterminations as one of the biggest challenges they face heading into next year.
Healthcare Law Blog
FEBRUARY 12, 2024
CMS approved $500 million in infrastructure spending for NYS to establish social care networks (“ SCNs ”) to provide HRSN screening and referral services to Medicaid beneficiaries that are targeted populations for HRSN services. Medicaid Hospital Global Budget Initiative CMS authorized up to $2.2
Fierce Healthcare
JANUARY 10, 2024
Elevance Health is launching a new initiative that aims to put smartphones in the hands of Medicaid members who otherwise cannot connect to virtual services. In the wake of the COVID-19 pandemic, virtual care and digital health tools are more popular than ever.
Healthcare Dive
DECEMBER 21, 2023
Enrollment in the Affordable Care Act exchanges could be boosted by extended subsidies and the effects of Medicaid redeterminations.
Fierce Healthcare
JANUARY 18, 2024
2024 | This week, Humana announced workforce reductions, a study associated Medicaid expansion with reduced lung cancer mortality and Bright Health moved its corporate headquarters. Below is a round-up of payer-centric news for the week of Jan.
Healthcare Dive
APRIL 25, 2023
The payer beat Wall Street expectations in the first quarter on both earnings and revenue, which reached $39 billion.
Healthcare It News
DECEMBER 29, 2023
This past week, New York Governor Kathy Hochul signed Senate Bill 1196a/Assembly Bill 1673a into law directing all state-regulated health plans, including Medicaid, to cover comprehensive biomarker testing, clearing the path for more patients to access precision medicine treatments.
Verisys
MARCH 12, 2024
Compliance Updates: March 2024 Overlook: Board Updates Georgia : The Georgia Medical Board has extended tele-prescribing flexibility until May 1, 2024. As of May 1, 2024, licensees should refer to the Medical Practice Act and Board Rules to ensure compliance with telemedicine practices. MD BOP Regulations 10.34.34.04
Medisys Compliance
APRIL 23, 2024
This comprehensive guide explores the key medical billing best practices for 2024, empowering healthcare providers to optimize their revenue cycle and minimize administrative burdens. Utilize resources from the Centers for Medicare & Medicaid Services (CMS) and your local healthcare associations.
HealthIT Answers
AUGUST 29, 2023
By Chris Emper - On July 13, the Centers for Medicare & Medicaid Services released a 1,920-page proposed rule that would update payment policies and programs regarding Medicare payments to physicians and other providers under the Physician Fee Schedule on or after January 1, 2024.
Fierce Healthcare
SEPTEMBER 26, 2023
Expect premiums, benefits and plan choices for Medicare Advantage (MA) and the Medicare Part D prescription drug program to look similar in 2024, the Centers for Medicare & Medicaid Services (C | CMS announced that nearly three-quarters of MA plan beneficiaries will not see their premiums rise.
Healthcare Dive
NOVEMBER 14, 2023
in the 2024 fiscal year — the largest year-over-year drop since 1998, according to KFF. Enrollment in the safety-net insurance program could plummet 8.6%
MedTrainer
JANUARY 10, 2024
It’s that time of the year to check your records for 2023 compliance deficiencies and set your organization up for success in 2024. Release of Industry-Specific Compliance Program Guidance (ICPG) is anticipated in 2024. It may seem a little early to do some spring cleaning, but not when it comes to compliance!
Verisys
MARCH 8, 2024
February 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Million Medicare and Medicaid Fraud Full Story Pharmacist Fraud Pharmacy Owner and Operations Manager Convicted of $2.3M The post February 2024 Bad Actors Roundup appeared first on Verisys.
Center for Health Insurance Reform
OCTOBER 19, 2023
A number of new and ongoing policy changes will impact the Marketplace in 2024, including special enrollment opportunities tied to the Medicaid “unwinding,” continuing enhanced financial assistance, and administrative flexibilities designed to reduce barriers to enrollment.
Verisys
FEBRUARY 8, 2024
The updated rules are effective January 2, 2024. NLC Final Rules Effective 1/2/2024 A new rule included in the Nurse Licensure Compact update affects nurses moving residence from one compact state to another compact state. Effective January 2, 2024. If the license is not renewed, it will expire on 8/2/2024.
Medisys Compliance
MARCH 7, 2024
In 2024, the AMA introduced 349 changes to the CPT code set, comprising 230 new codes, 49 deletions, and 70 revisions. Staying abreast of these 2024 CPT code updates is essential for healthcare professionals to ensure precise coding and proper financial reimbursement.
Compliance Now
AUGUST 10, 2023
As background, according to federal Health Insurance Portability and Accountability Act (HIPAA) rules, individuals have 60 days from losing CHIP and Medicaid eligibility to elect coverage under their group plan. The real potential of this number growing daily is what has prompted the Agencies to issue this “request.”
Verisys
FEBRUARY 9, 2024
January 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 The post January 2024 Bad Actors Roundup appeared first on Verisys.
Innovaare Compliance
DECEMBER 25, 2023
Summary of the HPMS Memo Generated by USHER (Inovaare’s AI-powered Compliance Assistant) The Centers for Medicare and Medicaid Services (CMS) issued a memorandum detailing several announcements relating to its 2024 CMS program audit. Prepare for both routine and focused audits to be conducted in 2024 by CMS.
Fierce Healthcare
APRIL 11, 2024
Payer Roundup—UHG exec stock sell-off after DOJ probe; Michigan awards Medicaid contracts; Cigna announce innovation hub home ntong Thu, 04/11/2024 - 15:39
Modern Healthcare
JULY 31, 2023
Skilled nursing faciltiies will receive a higher Medicare pay bump in fiscal 2024 than proposed by the Centers for Medicare and Medicaid Services in April.
Fierce Healthcare
JULY 13, 2023
The Centers for Medicare & Medicaid Services has released its proposed Medicare payment rates and policy updates under the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory S | The CY 2024 OPPS and ASC Payment System Proposed Rule includes a 2.8%
Healthcare IT Today
JANUARY 20, 2024
2024 Health IT Predictions : Cautionary Views of Healthcare AI. Our ongoing series of 2024 Health IT Predictions turned to some reasons to be wary of AI. Read more… 2024 Health IT Predictions: AI Use Cases in Healthcare. Read more… 2024 Health IT Predictions : AI’s Impact in Healthcare.
Healthcare IT Today
JANUARY 2, 2024
As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. All of this year’s 2024 health IT predictions (updated as they’re shared): John and Colin’s 2024 Healthcare IT Predictions And now, check out our community’s Health Equity predictions.
Medisys Compliance
APRIL 11, 2024
A New Era for Mental Health Access The landscape of mental healthcare in the United States underwent a significant change on January 1, 2024. The Centers for Medicare & Medicaid Services (CMS) website offers a comprehensive guide, including FAQs, enrollment instructions, and billing manuals specifically tailored for MFTs and MHCs.
Innovaare Compliance
MARCH 11, 2024
The Centers for Medicare & Medicaid Services (CMS) has been processing Part D drug claim data via the Drug Data Processing System (DDPS) since inception of Part D in 2006. Due to multiple changes to the Part D program pursuant to the Inflation Reduction Act (IRA) of 2022, some DDPS edit changes will take effect on January 1, 2024.
Compliancy Group
APRIL 17, 2024
Focus Areas for 2024 The OIG’s General Compliance Program Guidance (GCPG) establishes industry-specific compliance program guidance (ICPG) for 2024 that focuses on forms of fraud, waste, and abuse specific to certain types of suppliers, providers, and entities like nursing homes, clinical laboratories, and hospitals.
Medisys Compliance
APRIL 15, 2024
This article explores some of the key changes in urology CPT codes for 2024, empowering you to navigate the billing landscape with confidence. The 2024 CPT manual introduces new codes (0811T and 0812T) specifically for complex uroflowmetry performed remotely.
Modern Healthcare
AUGUST 18, 2022
States would have to track Medicaid and Children's Health Insurance Program quality metrics starting in fiscal 2024.
Provider Trust
JANUARY 25, 2024
Though HHS has made efforts to address the challenges outlined in this year’s report, there are still many opportunities for improvement in 2024. We’ve broken down the report’s primary themes and how they affect healthcare organizations moving forward in 2024. With Medicaid, the challenges are equally formidable.
Medisys Compliance
MARCH 10, 2024
Introduction Wound care billing in 2024 continues to be a dynamic and intricate aspect of healthcare administration, offering both challenges and opportunities for providers and coders. Prior Authorization Challenges and Strategies Another challenge in wound care billing in 2024 is navigating prior authorization requirements.
Healthcare IT Today
JANUARY 14, 2024
The American Telehealth Association announced its policy priorities for 2024 ; they include making Medicare telehealth flexibilities permanent before the end of the year and removing the in-person requirement for the remote prescribing of controlled substances. Wellness app Vivoo launched an at-home digital UTI test.
Innovaare Compliance
JANUARY 19, 2024
2] Through a combination of routine and focused audits in 2024, CMS aims to evaluate the UM-related performance of plans serving approximately 88% of people in MA plans. Audit notification will begin in January 2024. The post 2024 CMS Program and Focus Audits: Are You Prepared? What is the intent of a focus audit?
Center for Health Insurance Reform
JUNE 3, 2022
Beginning in 2023, CMS will require QHP provider networks for plans sold on the federal marketplace to meet minimum time-and-distance standards and, beginning in 2024, minimum standards for appointment wait times.
Healthcare IT Today
MARCH 9, 2024
Read more… Bonus Features for March 3, 2024: 75% of healthcare leaders expect widespread implementation of AI in 3 years, yet 78% of orgs lack knowledge on how to train employees to use AI. Dina raised $7 million in Series B funding ; the company supports network management for Medicare Advantage and Managed Medicaid.
Medisys Compliance
DECEMBER 12, 2023
As we move into 2024, several key updates will impact how behavioral health providers bill for their services. In this article, we will explore the most important behavioral health billing updates planned for 2024, focusing on both Medicare and commercial payers. This shift is expected to continue in 2024 and beyond.
Innovaare Compliance
DECEMBER 11, 2023
Before the Medicare Advantage Open Enrollment Period (MA OEP) [1] begins on January 1, 2024, Medicare Advantage Organizations (MAOs) still have time to review if they are completely ready for a new contract year. This blog article focuses on some of the “must make” changes to take effect as of January 1, 2024, or before. the disabled.
Center for Health Insurance Reform
MARCH 31, 2023
With the twin goals of building on the enrollment gains and improving the consumer experience, the Centers for Medicare & Medicaid Services (CMS) has proposed an annual set of requirements. Stakeholder Perspectives on CMS’s 2024 Notice of Benefit and Payment Parameters: Health Insurers
Healthcare IT Today
JANUARY 8, 2024
As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. There is a growing interest in the integration of safety services with technology, and this will continue into 2024. In fact, we got so many that we had to narrow them down to just the best and most interesting.
Health Care Law Brief
FEBRUARY 2, 2024
On Tuesday, January 16, 2024, Governor Kathy Hochul released the SFY 2025 New York State Executive Budget (“Executive Budget”). While still subject to legislative approval, the Executive Budget incorporates the recently approved amendment (“Waiver Amendment”) to New York’s Medicaid Section 1115 Demonstration that includes $7.5
Expert insights. Personalized for you.
We have resent the email to
Are you sure you want to cancel your subscriptions?
Let's personalize your content