It would lengthen the annual open enrollment period, expand the role of navigators and nix Trump-era guidelines for waivers that were criticized for allowing states to skirt coverage requirements. The Biden administration is planning to restore...
More InfoDive Brief: CMS does not have adequate authority to ensure that hospitals will be ready for the next pandemic, and wasn’t able to regulate them well enough to know whether they were maintaining quality and safety during the COVID-19 crisis...
More InfoCMS has released a proposed rule for the Home Health Prospective Payment System in CY22, which aims to expand value-based purchasing and address health equity. CMS has released the proposed rule for the Home Health Prospective Payment System next...
More InfoNew codes are effective Oct. 1, 2021. Highly anticipated, the fiscal year 2022 ICD-10-CM codes have been released by the Centers for Disease Control and Prevention (CDC), although still pending are the 2022 Official Coding and Reporting...
More InfoHHS recently extended the deadline to use COVID-19 relief funds to the end of the month, but some providers say they still need more time. The American Hospital Association (AHA) is seeking more time for healthcare providers with unspent COVID-19...
More InfoThe Health Resources and Services Administration (HRSA) has paid over 5 million claims for COVID-19 vaccinations of uninsured Americans, according to a recent announcement. The claims were paid through the HRSA COVID-19 Claims Reimbursement to...
More InfoThe National Academy of Medicine recently released a report urging everyone to have a primary care physician. The report went on to recommend that telehealth could have a role to play in this expansion of primary care. Dr. Josh Emdur is chief...
More InfoThe payer will debut its Medicare Advantage plans in select Arizona counties and expand coverage to additional counties in North Carolina and Nevada. Alignment Healthcare (Alignment) is extending its Medicare Advantage (MA) footprint in Arizona...
More InfoThe Supreme Court’s decision in California v Texas ended one lawsuit against the Affordable Care Act but may have left room for future legal action. Since the Supreme Court dismissed California v Texas on June 17, payers and healthcare leaders...
More InfoThe pandemic has only made the trend worse, as 33% of hospital executives report average claims denial rates of 10% or more. Hospital claim denial rates have hit new highs, with a 20% increase in those rates over the past five years, suggesting...
More InfoMerging the two health systems would create the largest system in Michigan, operating 22 hospitals and 305 outpatient centers, as well as a health plan. Michigan-based Beaumont Health and Spectrum Health have announced that they plan to merge to...
More InfoMACPAC’s June 2021 report to Congress included findings about non-emergency medical transportation benefits in Medicaid programs that could prove useful for benefits design. A small fraction of the Medicaid population utilizes non-emergency...
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