Managed Care Friday

3: The number of Walmart locations that the company is replacing with Oak Street Health clinics in the Dallas-Fort Worth area this fall. Newly public Oak Street has a network of 60 value-based primary care centers and the three new centers will offer preventative primary care and urgent care services focusing on patients of all ages. 5 and Dime: Payments focused on improving patient outcomes will be five to 10 times larger than what is contained in a typical outcomes-based, risk-bearing agreement under a new Blue Cross Blue Shield of Minnesota multiyear pact with Allina Health, a Minnesota...

CMS Releases 2021 IRF Final Rule

CMS has finalized Medicare policy updates for inpatient rehabilitation facilities (IRFs) in fiscal year 2021. The final rule implements many of the provisions included in the proposed rule, including changes to IRF coverage criteria and expanding the role of non-physician practitioners. Click to read more.

BRG Medicaid Update

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: –  AZ: State announces intent to increase FFS rates for variety of services –  CA: Legislature strengthens mental health parity; healthcare transaction oversight bill does not                      advance –  IN: State awards new managed care contract –  OH: State proposes to expand telehealth coverage on a permanent basis Click to read more.

BRG Quarterly Compliance and Program Integrity Developments

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 half of 2020, we have taken particular note of: –  DoJ/HHS enforcements/settlements –  Four OIG reports –  Two Comparative Billing Reports –  Five GAO reports –  Pending additions to the RAC audit list Click to read more.