FL Medicaid Postpones Proposed ABA Rate Cuts

Jul 16, 2019 | Autism, Medicaid

Florida's state Agency for Health Care Administration (AHCA) proposed several changes to Medicaid-covered behavior analysis services, including reimbursement reductions for providers who treat children with autism. However, after receiving strong feedback from providers, parents and advocacy groups, AHCA has announced it is postponing its proposed rate reductions. This brief reviews rates as well as the proposed stronger clinic licensure requirement, new multidisciplinary team approach, combined coverage policy, new electronic visit verification system, and provider enrollment moratorium...

HHS OIG Audit Process/Recent Home Health Activity

Jul 15, 2019 | Home Care, Home Health, Medicare

HHS OIG recently audited and found that a home health agency (HHA) incorrectly billed Medicare for beneficiaries who were not homebound and did not require skilled services. This OIG action provides an instructive example of OIG program integrity efforts across Medicare and particularly in the home health sector. Click to read more.

States Are Taking Different Approaches To Electronic Visit Verification

Jul 9, 2019 | Medicaid

In 2016 Congress took steps to address the growing Medicaid spending on personal care services (PCS) and increasing fraud cases involving PCS through an EVV mandate within the 21st Century Cures Act. States have flexibility in how they implement the requirement and a recent MACPAC brief shows that their approaches vary. Click to read more.