Recent Developments In OB/GYN

OB/GYN: Medicare FFS reimbursement for OB/GYN has been increasing in recent years due to E&M changes. There has been some program integrity developments around the specialty and Biden's Build Back Better package aims to increase Medicaid and CHIP postpartum coverage. Click to read more.

Managed Care Friday

Are You Walkin’ On Sunshine? If there’s a medical specialty that can claim this Katrina and the Waves hit, it’s probably the derms – skin cancer incidence is rising faster than an Olivia Rodrigo song on the charts and there aren’t enough dermatologists. Wait times are sometimes 3-4 months and, increasingly, it’s for the PA or NP not the dermatologist. The tele-derm experiment is a potential solution but a majority in our recent poll of 100+ doctors believe it will add cost, not limit skin cancer. But heading into 2022, these practitioners can evolve to impact health system costs in other...

Weekly Medicaid Update

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: AZ: Expanded MCO contract awards integrate physical and behavioral services for enrollees with SMI MO: Proposed increases to nursing facility rates NC: Delay in implementation of Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans TN: New MCO contract awards Click to read more.

CY 2022 Home Health Final Rule

Home Health: For CY 2022, CMS finalized policies that will increase Home Health Agency (HHA) payments by +3.2%. This reflects the net impact of a +2.6% rate increase and fixed-dollar loss and rural add-on adjustments. Click to read more.

CY 2022 ESRD Final Rule

End-Stage Renal Disease (ESRD): CMS has finalized a +1.9% increase to the ESRD base rate for CY 2022, and changes to the ESRD Treatment Choices (ETC) Model to continue to promote the use of home dialysis while addressing socioeconomic disparities between patients. Click to read more.