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Medicaid and Health Equity: CalAIM’s Bold Experiment

Healthcare Law Blog

More than 13 million people were enrolled in Medi-Cal in California in September 2021, making it the largest Medicaid program in the nation. In 2015, DHCS launched the WPC Pilots as part of its Medi-Cal 2020 Section 1115 Demonstration. MCPs may choose which ILOS to cover, in which counties, and to which members the ILOS are offered.

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2024 Final Rule: CMS Announces More Changes to Medicare Advantage but Declines to Reform the “60 Day Rule”

Health Care Law Brief

On April 5, the Centers for Medicare & Medicaid Services (“CMS”) released the 2024 Medicare Advantage and Prescription Drug Benefit Programs Final Rule (“Final Rule”), which will be codified at 42 C.F.R. The SRFs include low-income subsidy, dual eligibility (meaning eligible for Medicare and Medicaid) and disability.

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Massachusetts governor signs law safeguarding telehealth coverage

Healthcare IT News - Telehealth

"Coverage for telehealth services may include utilization review, including preauthorization, to determine the appropriateness of telehealth as a means of delivering a health care service; provided, however, that the determination shall be made in the same manner as if the service was delivered in person," read the bill.

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Health Provider News

Hall Render

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ million expansion ‘Very, very unusual.’

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Medicare Star Ratings 2021 Changes and Strategies to Address

Innovaare Compliance

It has become evident by changes to the Centers for Medicare & Medicaid Services (CMS) Star Rating formulas over the past several years—and especially with changes implemented for the 2021 Plan Year—that member experience and medication adherence is of utmost importance to the CMS. Medicare Star Ratings 2021 Changes.

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Health Provider News

Hall Render

Mary’s unveils new name, but mission remains unchanged UCHealth sues thousands of patients every year.

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Carceral Health Care Is Designed to Fail

Bill of Health

And we know that our prisons, jails, and detention centers employ doctors with suspended and limited licenses as the exclusive source for health care for incarcerated people. Carceral health care occurs within a regulatory vacuum. Compare, for example, federal treatment of nursing homes with prisons.

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