news and updates
Policy Watch – Provider-Based Clinics in the Wake of Section 603: What You Need to Know About CMS’ Proposed Rule
CMS’ July 6 release of the 2016 Proposed Medicare Outpatient Prospective Payment System (OPPS) rule begins to answer a few questions about how the so-called “site neutral” policy, hurriedly adopted late last year by Congress, may be implemented. But it leaves as many...
HRSA Posts FY2016 340B Pricing Program Audit
July 2016: HRSA Posts FY2016 340B Pricing Program Audit Results
July 2016
CMS Issues Proposed Hospital OPPS Rule, Changes to Reimbursement for Off-Campus Clinics
July 2016
CMS Issues Addendum to 2016 Medicaid Managed Care Rate Development Guide
July 2016
New FAQs on Medicaid Outpatient Drug Final Rule
Medicaid Managed Care
Key Resources on Medicaid Managed Care CMS Published Rules and Regulations Proposed Rule on New Pass-Through Payments CMS 2016 Final Medicaid Managed Care Rule CMS 2015 Proposed Medicaid Managed Care Rule CMS 2002 Final Medicaid Managed Care Rule CMS 2001 Proposed...
CMS Holds Webinar on Managed Care Provider Payments
July 12, 2016: CMS Holds Webinar on Plan and Provider Payments under New Medicaid Managed Care Rule
CMS Releases Proposed OPPS Rule for Outpatient Hospitals
July 6, 2016: CMS releases proposed rule for implementation of new Medicare payment methodology for hospitals outpatient department payments, scope of grandfathering.
June 2016
CMS Issues Guidance to States on Public Notice and the Process Requirements to Change Medicaid Provider Payment Rates through a SPA
May 2016
HRSA Pushes Back Expected Release of 340B Omnibus Guidance until December 2016
May 2016
CMS Issues Final Medicaid Managed Care Rule, Transitions Supplemental Pass-Through Payments for Providers
April 2016
CMS Issues Updated Guidance on FQHC Payment Methodologies Under Managed Care, Requires Medicaid Plans to Include at Least One FQHC
April 2016
CMS Issues 2017 Medicare IPPS Rule, Introduces New Formula for Medicare DSH Payments Beginning 2018
April 2016
HRSA Reopens Comment Period on 340B Program Manufacturer Price Ceiling and Penalty Rules
April 2016
CMS Finalizes Requirement that States Conduct Medicaid Access Reviews, Excludes Regular Reviews of Access to Hospital Services
February 2016
SMDL Outlining New Federal Restrictions on Medicaid Reimbursement for Outpatient Drugs, Including for 340B Entities
February 2016
CMS approves Alabama’s 1115 Medicaid waiver, establishing provider-based Regional Care Organizations and providing time limited incentive payments for quality improvement activities.
February 2016
President’s FY2017 budget proposal includes additional incentives for states to expand Medicaid, permanent DSH rebasing, CHIP extension, extended Medicaid primary care pay bump and cuts to Medicare IME and bad debt.