CMS Adds Health Plan Ratings to ACA Exchanges
August 20, 2019 | Eric D. Fader | Affordable Care Act | Legislation and Public Policy | Medicare and Medicaid | Private Insurers
The Centers for Medicare & Medicaid Services (CMS) announced on August 15 that health plans offered on health insurance exchanges will be ranked using a five-star quality rating system for the 2020 plan year open enrollment period that begins on November 1, 2019. The ratings will appear on both state-based exchanges and the federal exchange, …
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Medicare Physician Fee Schedule for 2020 Includes Telehealth Changes
August 15, 2019 | Eric D. Fader | Home Health | Legislation and Public Policy | Medicare and Medicaid | Telehealth
On July 29, the Center for Medicare and Medicaid Services (CMS) released its proposed revisions to the Medicare Physician Fee Schedule for 2020. The Proposed Rule was published in the Federal Register on August 14. CMS proposed to add three new codes for treatment of opioid use disorder to the list of services that are …
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Genetic Testing Scam Targets Medicare Beneficiaries
August 14, 2019 | Eric D. Fader | Fraud and Abuse | Medicare and Medicaid
The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Fraud Alert on August 13 regarding a genetic testing scam targeting Medicare beneficiaries. The scammers will offer a “free” screening for genetic testing but then submit a claim to Medicare, which will likely deny the claim as medically unnecessary. The …
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NY IPA Focuses on Social Determinants of Health
August 13, 2019 | Cassandra Rivais DiNova | Home Health | Legislation and Public Policy | Medicare and Medicaid | Private Insurers
On August 6, health insurer MVP Health Care announced an affiliation with Alliance for Better Health to address so-called social determinants of health in the Albany, New York area. The newly formed independent practice association (IPA), Healthy Alliance Independent Practice Association, is one of the first IPAs in the U.S. to focus exclusively on social …
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NY DOH Revises Policy for ASC Approval
August 6, 2019 | Benjamin P. Malerba | Ada Kozicz | Hospitals | Legislation and Public Policy
The New York State Department of Health (DOH) recently revised its policy regarding the review and approval process for Certificate of Need (CON) applications for ambulatory surgery centers (ASCs). The DOH’s current public need criteria favor the approval of new ASCs because they allow patients to obtain safe, low-cost and convenient surgical services outside a …
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