Plans should begin using the updated IDN no later than May 2, 2023 CMS updated an Office of Management and Budget-approved standardized Notice of Denial of Medical Coverage (or Payment), also known as the Integrated Denial Notice (IDN). Medicare health plans, including Dual-Eligible Special Needs plans (DSNPs),
Read More →HHS announced that the Public Health Emergency (PHE) for COVID-19 will end on May, 11, 2023. During the PHE, CMS used a combination of emergency authority waivers, regulations, enforcement discretion, and sub-regulatory guidance to ensure easier access to care during the PHE for healthcare providers and their beneficiaries.
Read More →It’s crucial that all contracting organizations accurately report parent organization status and legal entity name to CMS. All current and prospective MA, PDP, Cost, PACE and MMP organizations are requested to conduct annual reviews of the parent organization and legal entity name as listed in the Health
Read More →Highlights from HCCA 2023 Managed Care Compliance Conference Presentation by Anne Crawford, ATTAC Consulting Group | Sandra J. Durkin, Strategic Health Law Click here to see full presentation
Read More →Highlights from HCCA 2023 Managed Care Compliance Conference Presentation by Amanda Brown, ATTAC Consulting Group | Bailey Wendzel, Epstein, Becker Green Click here to see full presentation
Read More →Market Conduct Examination: How to Prepare for an Unpredictable Audit That Can Result in Major Fines
Many insurers in the commercial space have not yet undergone a market conduct exam, while others have not been tested on elements such as mental health parity Most plans have a well-defined process for responding to common state and federal audits. However, many plans are not as familiar
Read More →CMS released the Medicare Program; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, Medicare Parts A, B, C, and D Overpayment Provisions of the Affordable Care Act and Programs of All-Inclusive Care for the
Read More →CMS released the Medicare Program; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, Medicare Parts A, B, C, and D Overpayment Provisions of the Affordable Care Act and Programs of All-Inclusive Care for the
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 →Under guidance issued since Affordable Care Act (ACA) implementation, qualified health plans must provide coverage for specific benefit categories called essential health benefits (EHB). CMS is seeking public comment addressing various aspects of EHB covered by qualified health plans under ACA requirements. Comments must be received by
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