Dec 6, 2019 | Managed Care Friday
10,000: The number of psychiatrists across the country we’re missing, and 40% of the ones we do have do not take commercial health insurance, according to a panel of Medicaid behavioral health professionals who debated the issues at BRG’s healthcare leadership conference Thursday in Washington DC. Other takeaways: payers are asking providers to ‘please accept Medicaid and please make telehealth work’, and they see a growing need for transitional housing for patients swept up in the opioid crisis. Worried Well: As Archie once said, ‘why do they always give me a shot where the pain ain’t…?’ It...
Dec 4, 2019 | Behavioral, Medicare, Substance Abuse
CMS has finalized a bundled payment under the PFS for OUD treatment office-based services for 2020. This approach parallels the new bundled OUD treatment services for OTPs. Click to read more.
Dec 3, 2019 | LTCHs, Medicaid
After a year long procurement process, Texas has announced its STAR+PLUS awards. STAR+PLUS is Texas’s Medicaid Managed Care program, which integrates Acute Care services and Long-Term Services and Supports (LTSS) for people ages 65 or older, blind, or disabled. Click to read more.
Nov 25, 2019 | Home Infusion, Medicare
CMS maintained that payment under the new Medicare benefit for home infusion services will only be made on the days when a skilled professional is in the patient’s home, to the dismay of home infusion pharmacies who hoped that CMS would relax its statutory interpretation to expand the number of days reimbursed by Medicare. Click to read more.
Nov 22, 2019 | Managed Care Friday
1. 5: The amount of copay for a Physical or Speech therapy visit starting in 2020 for Cigna HMO members in Arizona, a change from the $20 this year. 2. Concierge Is Back, With A Twist: A company called Accolade will act as the “front door” concierge practice for life science manufacturer EMD Millipore’s 18,000 some employees. BCBS of Massachusetts will administer the benefits but Accolade will be the contact - handling care management, triage, steering members to care, and managing costs. Think of it as a new version of a benefit manager. 3. 2021 National Network: If you’re a physician group...
