On September 20, 2024, the Centers for Medicare & Medicaid Services (CMS) released the long-awaitedfinal ruleaddressing several important drug pricing matters under the Medicaid Drug Rebate Program (MDRP) (Final Rule). The Final Rule’s provisions also have significant ...
Medicaid Final Rule: Three top line issues to watchMara Baer, MPH
On December 28, 2024, a long-awaited Centers for Medicare & Medicaid Services (CMS) final rule became effective, significantly updating laboratory personnel requirements under Subpart M of the Clinical Laboratory Improvement...more CMS Cracks Down on Responsible Party Liability in LTC Admission Agreeme...
The Medicaid and Children’s Health Insurance Program Managed Care Access, Finance, and Quality Final Rule and the Ensuring Access to Medicaid Services Final Rule address state payments, medical loss ratios, home- and community-based services (HCBS) payments, and more. Medica...
Notably, the recently announced 2024 MMC final rule requires states to use independent entities to conduct annual secret shopper surveys or enrollee experience surveys to verify NAS compliance, which may help with improving oversight and enforcement.14 Second, to increase MH provider participation in ...
Ensure all necessary enrollee materials, both print and electronic versions, have been updated to reflect changes that occurred under the Final Rule 2024. Need Help to Ensure Your Plan is Ready for CY2024? We can help complete your readiness review, perform operational assessments and/or mock aud...
In its 2024 Physician Fee Schedule Final Rule released Nov. 2, CMSreducedoverall physician pay by 1.25% and updated the Medicare conversion factor to $32.74, a 3.4% decrease from last year. Nope, a fix wasn’t in any of the “continuing resolutions” Congress passed last year and earlier ...
The final rule for the 2022 Physician Fee Schedule was released on November 19, 2021. Among the provisions is a proposal to implement a new set of chronic care management codes to reimburse provider organizations managing care for an individual with just one chronic health condition requiring a ...
The study cites research from international bureaucracies (such as the IMF, OECD, and ECB) showing that spending caps are the only effective fiscal rule. Since I’ve already cited those reports (see here, here, here, here, here, and here), I won’t bother recycling that information. Suffi...
“The requirements in these final rules will have an impact on churn and help to ensure those who are eligible are able to enroll and maintain coverage.” Per the final rule, states cannot conductMedicaid renewalsmore than once a year, nor can they require in-person interviews for...