Weekly Medicaid Update

Sep 23, 2020 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: –  IN: State extends +4.2% Medicaid rate increase for NFs through September 30, 2020 –  NY: State identifies more than $700M in improper or questionable Medicaid payments –  PA: State updates guidance on retainer payments for IDD waiver providers Click to read more.

FY 2021 Final Rules for IPPS and LTCH

Sep 22, 2020 | Hospitals, Inpatient, LTCHs

CMS has finalized FY 2021 rules for the hospital inpatient prospective payment system (IPPS) and long-term care hospitals (LTCHs). This brief summarizes the proposed changes made to the IPPS, which applies to approximately 3,200 acute care hospitals, and LTCHs, which applies to approximately 360 LTCHs. Click to read more.

Managed Care Friday

Sep 18, 2020 | Managed Care Friday

74: Percent of medical directors from 103 plans we polled who say imaging studies for uncomplicated low back pain are a consistent problem, often ordered unnecessarily with the first month of diagnosis. Health plans like BCBS of Illinois say they have to collect and report this type of data to the National Committee for Quality Assurance. Like Pulling Teeth: A Midtown Manhattan dentist’s practice is thriving, despite being almost completely shut down for a few months during the peak of the pandemic. Why? Tooth fractures. The dentist, Dr. Tammy Chen, wrote in The New York Times that she’s...

Weekly Medicaid Update

Sep 16, 2020 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: –  National: CMS withdraws the proposed Medicaid Fiscal Accountability Rule (MFAR) –  AZ: State to implement new policy for coverage of behavior analysis services October 1, 2020 –  IL: State implements new training requirement for Medicaid Crisis Response providers –  PA: Bulletin addresses electronic visit verification for personal care Click to read more.