Fierce Healthcare

APRIL 5, 2024

Centers for Medicare & Medicaid Services finalized a host of actions ranging from broker compensation, health equity, mental health, supplemental benefits and biosimiliars, in the Contract Year | Medicare Advantage plans will need to adjust to new star ratings requirements, industry watchers warned following a final rule on Thursday.

Medicare 134

Medicare Medicare Medicaid Medicaid 134

Fierce Healthcare

JUNE 29, 2023

Medicare Advantage (MA) beneficiaries have less choice when it comes to finding a psychiatrist than Medicaid enrollees or those who buy coverage on the Affordable Care Act (ACA) marketplace do, acc | Medicare Advantage continues to grow, and so does the need for beneficiaries to have access to psychiatrists, says a study in Health Affairs.

ACA 109

ACA Medicaid Medicaid Medicare 109

Bill of Health

JANUARY 26, 2022

As a first step to protecting incarcerated individuals’ right to health, Congress should repeal the Medicaid Inmate Exclusion Policy (MIEP). The MIEP, established in 1965, prohibits Medicaid from covering incarcerated individuals, despite any prior eligibility. Specifically, states that have expanded Medicaid could save $4.7

Medicaid 293

Medicaid Medicaid COVID-19 Public Health 293

Healthcare Dive

AUGUST 23, 2023

Three Floridians, including two children, filed a lawsuit against the state on Tuesday alleging it illegally cut their Medicare coverage without proper notice.

Medicaid 246

Medicaid Medicaid Medicare Medicare 246

Healthcare Dive

DECEMBER 20, 2022

Lawmakers are rushing to speed passage of the $1.7 trillion omnibus spending package as they near a Friday deadline for government funding.

Medicaid 333

Medicaid Medicaid Medicare Medicare 333

Fierce Healthcare

JANUARY 25, 2024

The Centers for Medicare & Medicaid Services is seeking feedback on how to increase transparency around Medicare Advantage and improve data capabilities. |

Medicare 131

Medicare Medicare Medicaid Medicaid 131

Fierce Healthcare

JANUARY 9, 2024

Centers for Medicare & Medicaid Services approved New York's amended Medicaid section 1115 demonstration on Tuesday, spurring the agency to invest in behavioral health and health equity initiat | CMS is helping revamp Medicaid in New York, including more than $3 billion in investments for high-risk social needs services.

Medicaid 102

Medicaid Medicaid Medicare Medicare 102

Fierce Healthcare

FEBRUARY 21, 2024

Medicaid disproportionate share hospital (DSH) payments are being cut by $8 billion annually during the current and next four federal fiscal years under a new Centers for Medicare and Medicaid Serv | Published Tuesday and set to go into effect in two months, the final rule limits the calculation of a hospitals Medicaid shortfall to beneficiaries with (..)

Medicaid 104

Medicaid Medicaid Hospitals Medicare 104

Fierce Healthcare

DECEMBER 15, 2023

The Centers for Medicare & Medicaid Services is rolling out a new payment model that aims to support state Medicaid agencies in offering whole-person maternal care. |

Medicaid 104

Medicaid Medicaid Medicare Medicare 104

Fierce Healthcare

AUGUST 30, 2023

In a letter sent to all states (PDF), the Centers for Medicare & Medicaid Services ( | As more Medicaid beneficiaries are wrongly kicked off the program, CMS is requiring states to reevaluate its eligibility systems and auto-renewal process.

Medicaid 132

Medicaid Medicaid Medicare Medicare 132

Fierce Healthcare

NOVEMBER 20, 2023

Traditional Medicare paid out an estimated $31.2 The Centers for Medicare & Medicaid Services released its annual look at improper payments and found that the overall rate in Medicare was 7.38%, which sits below the 10% level mandated in statute.

Medicare 131

Medicare Medicare Medicaid Medicaid 131

Healthcare It News

APRIL 15, 2022

Postal Service and an online account this summer to connect with Medicaid enrollees about the expected end of the covid public health emergency, which will put many recipients at risk of losing their coverage. State Medicaid agencies for months have been preparing for the end of the public health emergency.

Medicaid 222

Medicaid Medicaid US Department of Health and Human Services Public Health 222

Fierce Healthcare

SEPTEMBER 19, 2023

The Centers for Medicare & Medicaid Services (CMS) finalized a rule Monday to streamline enrollment in Medicare Savings Programs (MSPs) with the aim of making coverage affordable for 860,000 mo | A $26.16 billion CMS rule will streamline Medicare Savings Program enrollment, reducing administrative burden in the process.

Medicare 118

Medicare Medicare Medicaid Medicaid 118

Fierce Healthcare

NOVEMBER 23, 2022

Google rolls out search features that aim to make it easier to sign up for Medicaid, Medicare. Wed, 11/23/2022 - 11:12.

Medicaid 126

Medicaid Medicaid Medicare Medicare 126

HIPAA Journal

NOVEMBER 21, 2022

million being defrauded from Medicaid, Medicare, and private health insurance programs. Five state Medicaid programs, two Medicare Administrative Contractors, and two private health insurers were tricked into changing the bank account details for payments. million, and $6.4 million, and $6.4

Medicaid 79

Medicaid Medicaid Medicare Medicare 79

The Health Law Firm Blog

APRIL 15, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule [.] Indest III, J.D.,

Medicare 52

Medicare Medicare Medicaid Medicaid 52

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.

Medicare 118

Medicare Medicare Medicaid Medicaid 118

HIPAA Journal

FEBRUARY 8, 2024

Department of Health & Human Services Office of Inspector General (HHS-OIG) has published a Roadmap for New Physicians on avoiding Medicare and Medicaid fraud and abuse. The post Advice for New Physicians on Avoiding Medicare and Medicaid Fraud and Abuse appeared first on HIPAA Journal.

Fraud 40

Fraud Medicaid Medicaid Medicare 40

Fierce Healthcare

SEPTEMBER 14, 2023

A third set of Medicare Part B prescription drugs will cost up to $618 less per average dose beginning Oct. 1, announced the Centers for Medicare & Medicaid Services (CMS). |

Medicare 129

Medicare Medicare Medicaid Medicaid 129

Healthcare Dive

APRIL 19, 2023

The payer said it was pleased with the recent CMS decision to phase in risk adjustment changes to the Medicare Advantage program that would allow it to “smooth the impact” to beneficiaries and providers.

Medicaid 246

Medicaid Medicaid Medicare Medicare 246

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.

Medicare 111

Medicare Medicare Medicaid Medicaid 111

Bill of Health

APRIL 13, 2022

When the PHE ultimately expires, this will also trigger the end of the Medicaid continuous enrollment requirement, under which states must provide continuous Medicaid coverage for enrollees through the end of the last month of the PHE in order to receive enhanced federal funding. Continuity of Coverage.

Medicaid 144

Medicaid Medicaid COVID-19 Public Health 144

Fierce Healthcare

FEBRUARY 20, 2024

Mental health provider Brightside Health bolstered its partnerships with Medicare, Medicaid and Medicare Advantage contracts throughout the country. Brightside Health has announced new payer partnerships with major plans to provide members with mental health care.

Medicare 68

Medicare Medicare Medicaid Medicaid 68

Healthcare IT News - Telehealth

JANUARY 11, 2023

The Kaiser Family Foundation recently looked at state trends with regard to expanding access to telehealth-based behavioral care during the pandemic and found that states see telemedicine as a key component of maintaining access to behavioral healthcare for Medicaid enrollees. WHY IT MATTERS. ON THE RECORD.

Medicaid 141

Medicaid Medicaid Medicare Medicare 141

Healthcare Compliance Blog

JANUARY 25, 2022

A Missouri woman who had previously pled guilty to Medicare and Medicaid fraud was sentenced in Federal Court to three years imprisonment and ordered to pay $7,620,779 in restitution. The DME companies would then submit the reimbursement claims to Medicare and Medicaid. General Legal Duties and Antitrust Laws.

Fraud 59

Fraud Medicaid Medicaid Medicare 59

Fierce Healthcare

NOVEMBER 4, 2021

5 to continue Medicare, Medicaid participation. CMS: Healthcare workers must receive their first COVID vaccine by Dec. Thu, 11/04/2021 - 09:51.

Medicaid 121

Medicaid Medicaid Medicare Medicare 121

Electronic Health Reporter

JANUARY 27, 2021

The Centers for Medicare and Medicaid Services (CMS) in recent months predicted both lower premiums and richer benefits for Medicare Advantage (MA) […]. The article 2021 Medicare Advantage Plan Intelligence: An Early Look appeared first on electronichealthreporter.com.

Medicare 155

Medicare Medicare Medicaid Medicaid 155

The Health Law Firm Blog

MARCH 25, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule [.] Indest III, J.D.,

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

DECEMBER 20, 2023

Finalized Revisions to Form CMS-855A For SNFs, the aforementioned data would be reported by completing the Form CMS-855A Medicare enrollment application (“CMS-855A” or “Form”). For NFs, the data would be reported via means prescribed by the applicable state Medicaid agency.

Nurses 40

Nurses Medicaid Medicaid Medicare 40

MedTrainer

APRIL 18, 2024

Behavioral health credentialing exploded in 2023 and 2024 as providers could enroll in Medicare for the first time. Download Now Common Challenges in Behavioral Health Credentialing Where behavioral health credentialing diverges from typical provider credentialing is Medicare enrollment.

Medicare 52

Medicare Medicare Licensing Compliance 52

Healthcare Dive

SEPTEMBER 29, 2023

The Congressional Budget Office report estimated the Center for Medicare and Medicaid Innovation, which was created in part to reduce spending, will increase net federal spending by $1.3 billion from 2021 through 2030.

Medicaid 310

Medicaid Medicaid Medicare Medicare 310

Fierce Healthcare

JULY 20, 2023

The Centers for Medicare & Medicaid Services (CMS) has approved proposals from California and Kentucky for community-based mobile crisis intervention teams to provide Medicaid crisis services.<

Medicaid 98

Medicaid Medicaid Medicare Medicare 98

Fierce Healthcare

DECEMBER 7, 2023

Centers for Medicare & Medicaid Services is considering expanding the national coverage determination for allogeneic hematopoietic stem cell transplants using bone marrow or peri | A new request from CMS would give full coverage of stem cell treatments to Medicare patients with myelodysplastic syndromes, a deadly condition that can progress to (..)

Medicare 77

Medicare Medicare Medicaid Medicaid 77

Modern Healthcare

JULY 3, 2023

Nursing homes, rehab providers and psychiatric hospitals urged the Centers for Medicare and Medicaid Services to account for economic conditions in fiscal 2024 rates

Medicare 93

Medicare Medicare Nursing Homes Medicaid 93

Fierce Healthcare

JULY 13, 2023

The Centers for Medicare & Medicaid Services (CMS) is recommending preexposure prophylaxis (PrEP) with oral or injectable antiretroviral therapy to people at risk of HIV without patient cost sh | A new proposal would allow Medicare beneficiaries to protect themselves against HIV without cost-sharing through preexposure prophylaxis and antiretroviral (..)

Medicare 98

Medicare Medicare Medicaid Medicaid 98

Electronic Health Reporter

MAY 8, 2020

The article Medicaid, Medicare and Telehealth: What the Pandemic Has Taught Us appeared first on electronichealthreporter.com. As the coronavirus outbreak limits individual movement across the country, organizations are turning to remote solutions to stay operational.

Medicaid 79

Medicaid Medicaid Medicare Medicare 79

Healthcare Dive

NOVEMBER 8, 2023

Medicare Advantage stars, Medicaid redeterminations, individual exchange growth and GLP-1s. Many payers beat Wall Street expectations in the quarter, despite ongoing utilization concerns. Other hot topics?

Health Insurance 273

Health Insurance Medicaid Medicaid Medicare 273