Nov 6, 2019 | Behavioral, Home Health, Medicare
CMS finalized rates and policies for implementation of the Patient-Driven Groupings Model for Medicare home health, beginning on January 1, 2020. After significant industry pushback, the agency halved the reduction to rates it was making to account for provider behavioral responses to the new payment system, as required by Congress. Click to read more
Sep 19, 2019 | Medicare, Substance Abuse
CMS has proposed adding substance use disorder (SUD) services to the Medicare fee schedule, including medication assisted therapies (MAT) for opioid treatment disorder (OUD) and expanded management and counseling services. Click to read more.
Sep 18, 2019 | Medicaid, Substance Abuse
According to an Urban Institute study, Medicaid-covered prescriptions for buprenorphine, which is used to treat opioid addiction, increased dramatically in states that expanded Medicaid. Click to read more.
Aug 28, 2019 | Inpatient Psych, Medicare
CMS has finalized the Inpatient Psychiatric Facility (IPF) rule for FY2020. The rule has no major policy changes and updates rates by +1.75% which combined with adjustments to the outlier threshold is projected to increase IPF payments by +1.5%. Click to read more.
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...
Apr 29, 2019 | Behavioral, Inpatient Psych
CMS recently released proposed updates to the Inpatient Psychiatric Facilities (IPF) Prospective Payment System (PPS). The proposed rule is stable for IPFs, with an estimated update to prospective payment rates of 1.7%, and the addition of one measure to the IPF Quality Reporting Program. Click to read more.
