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.”
Read More →– Charles Baker, VP, Compliance Solutions The transition of Medicare-Medicaid Plans (MMPs) to Dual-Eligible Special Needs Plans (D-SNPs) by the end of 2025 marks a significant change in healthcare delivery. This shift demands a comprehensive approach due to the complex regulatory ecosystem; it’s essential for health plans to
Read More →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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