Proposal also seeks to increase information to patients. New proposals to improve the prior authorization process, while giving patients information on the status of prior
Claim denials for children 21 years of age or younger should be disputed through EPSDT. As you know, many states have expanded Medicaid. I am
Five years ago, the Centers for Medicare & Medicaid Services (CMS) first compiled a list of services that the newly implemented recovery audit contractor (RAC)
The fate of these hospitals looks grim. Rural hospitals have long been considered “on the edge.” They typically serve populations that are old, less affluent,
Double-dipping has been seen among some Managed Care Organizations. How many readers have undergone more than one audit? What about more than one audit for
The proposed rule is designed to reduce red tape associated with enrollment in Medicaid and related programs. In a move that some might surmise as
How many times have we panelists talked about COVID and COVID exceptions to the regulatory rules? How many times have we warned providers that the
Benefits are largely dictated by how each state manages its Medicaid program. The MACPAC (different from the RACs, or Recovery Audit Contractors) stands for the
Readmission reduction has become something of a Holy Grail: always just beyond reach. Elegant solutions risk creating a negative return on investment (ROI) or prove
This article will explore Medicaid expansion during COVID-19. We all know that COVID has uprooted our lives. Telehealth is the new post-COVID norm, whereas it
And then there were 12: Medicaid expansion, COVID-19, and the SDoH Elections in Missouri last week moved that state into the expansion fold. Voters approved
Telehealth and Medicaid eligibility nuances are expected to be future hot topics of RAC and MAC audits. Someday, around a campfire, we will tell our
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