States begin Medicaid redetermination efforts on April 1, 2023 States will start Medicaid redetermination efforts on April 1, 2023. The Consolidated Appropriations Act, 2023 effectively terminated previous requirements that the redetermination period would begin at the end of the Public Health Emergency. If states meet the requirements, they’ll
Read More →The CDC released ICD-10 code changes that go into effect April 1, 2023. All of the code changes are related to improving the capture of Social Determinants of Health (SDOH) information. There are 42 code changes aimed at improved specificity when documenting SDOH conditions, including classifications of:
Read More →If you plan to enter the value-based insurance design (VBID) market, it’s important to understand the goal of the program in order to make decisions on how to structure it. VBID is a strategy that minimizes or eliminates out-of-pocket costs for high-value services in defined patient populations.
Read More →Amanda Brown, VP for Compliance Solutions and Anne Crawford, Senior Vice President for Compliance Solutions, will speak at HCCA’s 2023 Virtual Managed Care Compliance Conference. The virtual event is dedicated to compliance management for health plan providers. Jennifer Venditti, Senior Vice President, Business Transformation and Technology and
Read More →The demand for administrative simplification, particularly related to prior authorization, continues to increase On December 15, 2022, the Department of Health and Human Services (HHS) issued a proposed rule for the Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and
Read More →Are you prepared for your health plan’s next big project? Do you have the skills and time to tackle the project? As you consider these questions, here are five key considerations that contribute to the success of any project. 1. Ensure that everyone understands the project or program
Read More →As required by CMS, each state is developing its plans for the 12-month unwinding period in anticipation of the end of the public health emergency (PHE). On October 13, 2022, the U.S Department of Health and Human Services announced renewal of the PHE, extending it an additional
Read More →CMS recently announced a change that impacts enrollment information for Medicare Advantage and Part D plans. The new race and ethnicity data will be required for all enrollments after January 1, 2023. CMS plans to use the race and ethnicity data to better track and solve disparities
Read More →
