Breaking Barriers, Bridging Gaps: Collaborative Solutions for Improving Behavioral Health Access and Documentation

Breaking Barriers, Bridging Gaps: Collaborative Solutions for Improving Behavioral Health Access and Documentation

by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment  CMS recently announced its Innovation in Behavioral Health Model, intended to “improve quality of care, access, and outcomes for people with mental health conditions and substance use disorders in Medicaid and Medicare.”

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2025 Medicare Advantage Reforms: A Comprehensive Shift Towards Equity, Transparency and Patient-centered Care

2025 Medicare Advantage Reforms: A Comprehensive Shift Towards Equity, Transparency and Patient-centered Care

Charles Baker, VP, Compliance Solutions The Centers for Medicare & Medicaid Services (CMS) continues to build upon its strategy to support person-centered, value-based care through the 2025 Medicare Advantage and Part D programs proposed rule. These proposals, a bold stride towards enhancing health equity, transparency, and patient-centric

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Get Ready: 2024 Low-Income “Extra Help” Subsidy Changes 

Health plans should now prepare to implement changes, including developing member retention and acquisition strategies To improve access and affordability of prescription drugs for low-income beneficiaries, the Inflation Reduction Act of 2022 eliminated the partial low-income subsidy (LIS) benefit beginning in 2024. This change will move Medicare beneficiaries

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New Proposed Medicaid Regulations Aim to Enhance Access to Care & Health Equity | Submit Comments by July 3, 2023

New Proposed Medicaid Regulations Aim to Enhance Access to Care & Health Equity | Submit Comments by July 3, 2023

The proposed rule, Ensuring Access to Medicaid Services, includes changes to existing requirements and introduces new requirements. The proposed regulations advance CMS’s efforts to improve access to care, quality and health outcomes; the regulations are intended to promote health equity across fee-for-service (FFS) and managed care delivery

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How to Prepare for Medicaid Redetermination

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

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