Managed Care Friday

Sep 11, 2020 | Managed Care Friday

80: The amount of new counties Cigna is adding individual plans in for 2021, increasing their ACA market size by 27%. Key benefits included in some of the plans are no copay for virtual visits, including behavioral health providers, a new diabetes care plan that includes no copay for diabetes equipment and supplies, and increased coverage for nontraditional healthcare services, like acupuncture. Oral Health Uptick: Kaiser Permanente and Delta Dental of Washington have partnered to launch Health360, a medical-dental plan focused on better overall outcomes and a lower total cost of care. The...

BRG Medicaid Update

Sep 9, 2020 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: –  CA: State Legislature passes law authorizing NPs to practice independently –  FL: AHCA adds new temporary services and requirements for Adult Day Care providers –  PA: State distributes CARES Act funding for direct care workers Click to read more.

2021 PFS Proposed Rule: Changes Beyond E&M Reform

Sep 8, 2020 | Labs, Physician Fee Schedule, Physicians

In addition to proposing to reform office visit codes, the 2021 PFS proposed rule includes several other notable policies. This brief outlines those provisions, including telehealth, orthopedics, vascular surgery, substance use disorder, care management, dermatology, GI, ophthalmology, pathology, labs, FQHCs, and ACOs. Click to here to read more.

CMS Proposes Policy Changes for Outpatient Hospital and ASCs

Sep 8, 2020 | ASC, Outpatient

In addition to a standard +2.6% rate update to the outpatient hospital payment system, CMS is proposing to eliminate the inpatient-only list for all procedures by 2024. After a recent court ruling in CMS’s favor, the agency also proposes to cut reimbursement for 340B-eligible drugs to ASP-28.7% from ASP-22%. Click to here to read more.