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Managing Healthcare Compliance in Missouri

MedTrainer

Healthcare compliance in Missouri is uniquely challenging due to state-specific regulations, such as the surgical smoke plume evacuation system requirement. This article provides a concise overview of Missouri’s healthcare compliance, highlighting the state-specific requirements to be aware of.

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ACA Health Plans — Key considerations for staying relevant

Innovaare Compliance

A perspective on recent industry shifts influencing ACA plan operations in states, which are yet to adopt ACA Medicaid expansion Health Exchange plans covered under ACA (Accountable Care Act) witnessed 36% enrollment growth between 2021 and 2023. This is the sharpest rise in ACA enrollment since inception.

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Understanding Basics of Alternative Payment Models (APMs)

Medisys Compliance

In October 2021, the Center for Medicare and Medicaid Innovation (CMMI) announced a goal of having every Medicare beneficiary and the majority of Medicaid beneficiaries covered by some type of alternative payment model (APM) by 2030. Incentives for Medicaid clinicians who also treat Medicare patients. APMs Overview.

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CMS Includes MAOs in Data Exchange and Prior Authorization Requirements

Healthcare Law Blog

The Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule , “Advancing Interoperability and Improving Prior Authorization Processes” (the “Proposed Rule”), that is intended to improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services.

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CMS Promotes Competition, Transparency, Health Equity and More in the CY2025 Medicare Advantage and Part D Proposed Rule

Healthcare Law Blog

On November 6, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released the contract year 2025 proposed rule for Medicare Advantage (“MA”) organizations and Part D sponsors (the “Proposed Rule”). This proposal would shift the burden from CMS to the MA organization to demonstrate compliance with this standard.