Managed Care Friday

7: The percentage of medical residents who feel adequately prepared to manage women experiencing menopause. More women are seeking hormone therapy and menopausal treatment services, with 83 percent in a recent BRG survey reporting an increase in these claims, but more women are growing dissatisfied with the care they’re offered. Alternative care models, including virtual menopausal treatment companies like Midi Health and Gennev, have risen in popularity. Read more about this and more in our recent Women’s Health whitepaper – click here. UTI Response: Blue Cross NC recently began sending...

Recent Developments in Pathology

Recent Developments in Pathology: Medicare FFS pathology codes have been negatively affected by budget neutrality adjustments due to E&M reform. Pathology specialty spend has experienced modest fluctuations in recent years. Click here to read more.

Weekly Medicaid Update

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: CO: Delays removal of some prior authorization requirements for speech therapy PA: CMS approves $42M in additional funding for Money Follows the Person program GA: Increases for some OBGYN codes Click to read more.

Recent MedPAC & MACPAC Activity

Recent MedPAC & MACPAC Activity: MedPAC recommends aligning payment across the three ambulatory settings and MACPAC examines barriers to home and community-based services. Click here to read more. 

CY 2024 Proposed ESRD Rule

CY 2024 Proposed ESRD Rule: The proposed rule would increase base rates by +1.7% and would result in a +1.6% increase in payments. Click here to read more. 

Managed Care Friday

740,000: Number of New Yorkers with medical debt on their credit reports as of February 2022 – that's 6% of all residents in the Empire state. A report by the Urban Institute found that NY communities with the highest prevalence of medical debt also faced additional challenges in accessing healthcare – high-debt communities were more rural, had higher rates of disability, and had lower rates of employment. A bill that passed New York State Legislature last month and is awaiting the governor’s review would prevent all medical debt from being included in credit reports. AI Making Care...

Weekly Medicaid Update

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: IL: Directed payments for assertive community treatment (ACT) and community support team (CST) mental health providers LA: Continuous glucose monitors shift from DME to pharmacy benefit WA: Will submit SPA to add Dental Health Aide Therapist (DHAT) coverage Click to read more.