Aug 18, 2023 | Managed Care Friday
66: Percent of adults in the US who have a personal or familial experience with alcohol or drug addiction, according to a new KFF poll, highlighting how substance use disorders affect not only individuals but also their friends and family. 27% of adults who have a relative with an addiction report that their mental health was significantly affected by it, but only 46% got treatment. Bye Bye Pre Approval? United Healthcare will begin a two-phased approach to eliminating some prior authorization requirements in September. This will occur across commercial, MA and Medicaid plans and most...
Aug 17, 2023 | Hospitals, Inpatient, LTCHs, Medicare
CMS Releases Final Inpatient Prospective Payment (IPPS) and Long-Term Care Hospital (LTCH) Rule: The IPPS rule increases rates by +3.1% and CMS estimates hospital payments for the approximately 3,100 acute care hospitals will increase by a total of $2.2B. CMS expects the LTCH standard payment rate to increase by +3.3%. Click to read more
Aug 17, 2023 | Medicare, Physician Fee Schedule, Physicians
CMS Announced Proposed Physician Fee Schedule (PFS) Rule: The proposed rule would reduce the conversion factor by -3.4% for 2024. CMS projects $89B in fee-for-service (FFS) allowed charges, $2B less than estimated during 2023 final rulemaking. Click to read more
Aug 15, 2023 | Drugs, Medicare
CMS Releases Inflation Reduction Act (IRA) Guidance for Medicare Drug Price Negotiations: Guidance was revised to improve transparency and support an effective negotiation process. On September 1, 2023 CMS will publish the first ten drugs selected for negotiation. Click here to read
