Trump Administration to States: We Will Trade More Medicaid Managed Care for Less Oversight

Thomas Johnson

On March 23, 2018, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that would provide for a reduction of administrative burden with states that have high rates of Medicaid managed care enrollment. In the past, states with high enrollment have raised concerns regarding administrative burden when they have to determine whether Medicaid payments in Fee-for-Service systems are sufficient to enlist providers to ensure beneficiary access to covered care and services consistent with the statute.

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Lack of Staff: Biggest Hurdle to Success

Regan Pennypacker

Staffing continues to be a major hurdle in the healthcare industry. A recent poll conducted by Gorman Health …

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Is it the End of the Medicare Marketing Guidelines as we Know Them?

Betsy Seals

For those of us who have worked for years in the marketing and sales arena, the release of …

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The 2019 Final Notice of Benefit & Payment Parameters

Jessica Smith

The Department of Health and Human Services (HHS) Notice of Benefit and Payment Parameters (NBPP) for 2019 final …

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Work Requirements in Medicaid: The True Costs

Thomas Johnson

Many states are looking to add work requirements for their Medicaid recipients. The “fever” that has spread with …

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The 2019 Final Call Letter: Stability & No Unexpected Surprises in Star Ratings

Melissa Smith

The Centers for Medicare & Medicaid Services (CMS) Star Ratings updates in the 2019 Final Call Letter offer …

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Spotlight on Risk Adjustment in 2019 Final Call Letter for Medicare Advantage & Part D

Jessica Smith

The Centers for Medicare & Medicaid Services (CMS) released the Final Call Letter on April 2, 2018. The …

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