Weekly Medicaid Update

Apr 26, 2023 | Uncategorized

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: FL: Ending telehealth and other flexibilities for behavioral analysis providers​ IN: Expanding telehealth originating site facility fee to additional providers​ OH: House budget includes dental and in-home caregiver rate increases​ WA: Nursing homes to get a +13.6% Medicaid rate increase​ Click to read more. 

BRG Quarterly Compliance Developments

Apr 25, 2023 | BRG Publications

The BRG Healthcare Transactions and Strategy quarterly compliance bulletin compiles noteworthy developments in the healthcare sector related to compliance, program integrity, and enforcement activities. In the first quarter of 2023, we have taken note of: DOJ/HHS Activity OIG Reports on Epidural Steroid Injection and Spinal Facet-Join Interventions OIG Workplans Three Comparative Billing Reports One Approved RAC Topic One GAO Report OCR Activity Click to read more. 

Managed Care Friday

Apr 21, 2023 | Managed Care Friday

1 In 575: The average ratio of psych counselors to students based on our poll of 340 school districts in 19 states.  We learned that the proportion of calls to 911 or 988 related to a suicide situation were about 4-5 times more likely in the schools that had to rely on an extremely high case load for each counselor.    New PBM Pricing Model: Express Scripts has launched a new pricing model called ClearCareRx to allow employers, health plans, and government employers to pay exactly what Express Scripts pays for drugs. ESI’s new copay assurance plan will cap copays for members – $5 for...