California revises Medicaid contract awards, adding 2 insurers
Healthcare Dive
JANUARY 4, 2023
Five insurers will now receive lucrative contracts to provide managed care services, starting in 2024, in the country's largest Medicaid market.
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Healthcare Dive
JANUARY 4, 2023
Five insurers will now receive lucrative contracts to provide managed care services, starting in 2024, in the country's largest Medicaid market.
Healthcare Dive
DECEMBER 21, 2023
Enrollment in the Affordable Care Act exchanges could be boosted by extended subsidies and the effects of Medicaid redeterminations.
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Healthcare It News
DECEMBER 29, 2023
This past week, New York Governor Kathy Hochul signed Senate Bill 1196a/Assembly Bill 1673a into law directing all state-regulated health plans, including Medicaid, to cover comprehensive biomarker testing, clearing the path for more patients to access precision medicine treatments.
Healthcare Dive
APRIL 25, 2023
The payer beat Wall Street expectations in the first quarter on both earnings and revenue, which reached $39 billion.
Healthcare Dive
JULY 28, 2023
The payer lost 262,700 Medicaid members in the second quarter, dropping its total Medicaid lives to just over 16 million.
Fierce Healthcare
NOVEMBER 14, 2023
Medicaid enrollment is projected to slide further next year, according to an annual budget survey of Medicaid officials conducted by KFF and Health Management Associates in collaboration with the N | State Medicaid directors once again see redeterminations as one of the biggest challenges they face heading into next year.
Fierce Healthcare
JANUARY 10, 2024
Elevance Health is launching a new initiative that aims to put smartphones in the hands of Medicaid members who otherwise cannot connect to virtual services. In the wake of the COVID-19 pandemic, virtual care and digital health tools are more popular than ever.
Healthcare Dive
APRIL 25, 2024
Despite business growth in the first quarter, Molina reiterated its prior 2024 guidance out of caution that it won’t be able to reprocure the contested contracts.
Healthcare Dive
NOVEMBER 14, 2023
in the 2024 fiscal year — the largest year-over-year drop since 1998, according to KFF. Enrollment in the safety-net insurance program could plummet 8.6%
Fierce Healthcare
JANUARY 18, 2024
2024 | This week, Humana announced workforce reductions, a study associated Medicaid expansion with reduced lung cancer mortality and Bright Health moved its corporate headquarters. Below is a round-up of payer-centric news for the week of Jan.
Fierce Healthcare
MAY 10, 2024
Below is a roundup of payer-centric news headlines you may have missed during the month of May 2024. This month, Iowa signed into a law a postpartum Medicaid expansion, L.A. Care Health commited $3 million to providers, Aetna settled a lawsuit alleging fertility discrimination, a former NBA champion was sentenced to prison and more.
Fierce Healthcare
SEPTEMBER 26, 2023
Expect premiums, benefits and plan choices for Medicare Advantage (MA) and the Medicare Part D prescription drug program to look similar in 2024, the Centers for Medicare & Medicaid Services (C | CMS announced that nearly three-quarters of MA plan beneficiaries will not see their premiums rise.
HIT Consultant
JULY 16, 2024
Anish Sebastian, CEO and Co-founder, Babyscripts A discussion of technology and the Medicaid population inevitably raises the topic of the digital divide — that is, the gap between people who have access to modern information and communications technology (ICTs) and those who don’t. “We But there’s a lot of reasons to be optimistic.
Center for Health Insurance Reform
OCTOBER 19, 2023
A number of new and ongoing policy changes will impact the Marketplace in 2024, including special enrollment opportunities tied to the Medicaid “unwinding,” continuing enhanced financial assistance, and administrative flexibilities designed to reduce barriers to enrollment.
HealthIT Answers
AUGUST 29, 2023
By Chris Emper - On July 13, the Centers for Medicare & Medicaid Services released a 1,920-page proposed rule that would update payment policies and programs regarding Medicare payments to physicians and other providers under the Physician Fee Schedule on or after January 1, 2024.
Center for Health Insurance Reform
JUNE 3, 2022
Beginning in 2023, CMS will require QHP provider networks for plans sold on the federal marketplace to meet minimum time-and-distance standards and, beginning in 2024, minimum standards for appointment wait times.
Healthcare IT Today
JANUARY 4, 2024
As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. We believe that trend will accelerate further in 2024 as obesity medication options and supply grow. In 2024, nurse leaders will drive the paradigm shift toward AI-enabled virtual nursing.
Healthcare IT Today
JANUARY 5, 2024
As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. With legislation currently being drafted for nurses to receive the same reimbursement doctors and physicians do, this will likely become a top-of-mind topic in 2024.
Healthcare IT Today
JANUARY 16, 2024
As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. Florian Otto, CEO and Co-founder at Cedar Healthcare Affordability: Healthcare affordability will always be a problem, and it remains to be seen if 2024 will be better or worse than 2023.
MedTrainer
JANUARY 10, 2024
It’s that time of the year to check your records for 2023 compliance deficiencies and set your organization up for success in 2024. Release of Industry-Specific Compliance Program Guidance (ICPG) is anticipated in 2024. It may seem a little early to do some spring cleaning, but not when it comes to compliance!
Healthcare IT Today
JANUARY 10, 2024
As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. Jason Considine, Chief Commercial Officer at Experian Health Staffing shortages will continue to be a major pain point for providers in 2024 and have a direct impact on their bottom line. Morgenstern.
Compliance Now
AUGUST 10, 2023
As background, according to federal Health Insurance Portability and Accountability Act (HIPAA) rules, individuals have 60 days from losing CHIP and Medicaid eligibility to elect coverage under their group plan. The real potential of this number growing daily is what has prompted the Agencies to issue this “request.”
Compliance Now
AUGUST 10, 2023
As background, according to federal Health Insurance Portability and Accountability Act (HIPAA) rules, individuals have 60 days from losing CHIP and Medicaid eligibility to elect coverage under their group plan. The real potential of this number growing daily is what has prompted the Agencies to issue this “request.”
HIT Consultant
APRIL 19, 2024
Medicare providers in hospitals and skilled nursing facilities (SNFs) are adjusting to new split/shared services documentation and billing regulations rolled out by the Centers for Medicare and Medicaid Services (CMS) as part of the 2024 Medicare Physician Fee Schedule (MPFS) final rule.
Fierce Healthcare
JULY 13, 2023
The Centers for Medicare & Medicaid Services has released its proposed Medicare payment rates and policy updates under the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory S | The CY 2024 OPPS and ASC Payment System Proposed Rule includes a 2.8%
Center for Health Insurance Reform
MARCH 31, 2023
With the twin goals of building on the enrollment gains and improving the consumer experience, the Centers for Medicare & Medicaid Services (CMS) has proposed an annual set of requirements. Stakeholder Perspectives on CMS’s 2024 Notice of Benefit and Payment Parameters: Health Insurers
Healthcare IT Today
JANUARY 14, 2024
The American Telehealth Association announced its policy priorities for 2024 ; they include making Medicare telehealth flexibilities permanent before the end of the year and removing the in-person requirement for the remote prescribing of controlled substances. Wellness app Vivoo launched an at-home digital UTI test.
HIT Consultant
SEPTEMBER 27, 2024
Power 2024 U.S. Power 2024 U.S. The data is based on responses from 4,070 healthcare customers who utilized telehealth services in the past year, collected between September 2023 and July 2024. Telehealth Satisfaction Study. Study Background/Methodology The J.D.
Fierce Healthcare
JUNE 4, 2024
SCAN Health Plan secured a court victory Monday when a federal judge agreed that the Centers for Medicare & Medicaid Services (CMS) inappropriately calculated its star ratings for the 2024 plan | SCAN Health Plan secured a court victory Monday when a federal judge agreed that the Centers for Medicare & Medicaid Services inappropriately calculated (..)
Healthcare It News
OCTOBER 31, 2022
With the Centers for Medicare & Medicaid Services mandating hospitals be ready to report on SDOH screening quality in 2024, a multi-stakeholder effort to advance an FHIR-based approach is needed to help providers meet CMS requirements, according to HL7 CEO Dr.
Fierce Healthcare
JULY 26, 2024
Centene beat the Street even as Medicaid redeterminations pose a significant headwind heading into the back half of 2024, according to its
Healthcare IT Today
JANUARY 8, 2024
As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. There is a growing interest in the integration of safety services with technology, and this will continue into 2024. In fact, we got so many that we had to narrow them down to just the best and most interesting.
Healthcare It News
APRIL 5, 2024
During open enrollment for the 2024 plan year, the AI agent handled 14.5% of calls to affiliated brokers or Nevada Medicaid – about 2,100 additional calls. of the call center's demand, approximately 2,700 calls. Also, it transferred another 9.6%
Healthcare IT Today
MARCH 9, 2024
Read more… Bonus Features for March 3, 2024: 75% of healthcare leaders expect widespread implementation of AI in 3 years, yet 78% of orgs lack knowledge on how to train employees to use AI. Dina raised $7 million in Series B funding ; the company supports network management for Medicare Advantage and Managed Medicaid.
Compliancy Group
DECEMBER 18, 2024
In just the first three quarters of 2024, 155 providers have been added to the Texas Health and Human Services Commission Medicaid exclusion list. Over 4 million people in Texas are covered by Medicaid, and the Texas OIG exclusion list provides protection for each of them, as well as for healthcare facilities.
Modern Healthcare
JULY 31, 2023
Skilled nursing faciltiies will receive a higher Medicare pay bump in fiscal 2024 than proposed by the Centers for Medicare and Medicaid Services in April.
HIT Consultant
NOVEMBER 22, 2024
Expand Medicaid: Establish a federal fallback option to cover the millions of uninsured individuals in states that have not expanded Medicaid. Promote Continuous Coverage: Allow states to maintain continuous Medicaid eligibility for adults for 12 months to prevent gaps in coverage.
Fierce Healthcare
NOVEMBER 4, 2024
Days before the 2024 presidential election, the Centers for Medicare & Medicaid Services (CMS) released an unpublished version of the final calendar year 2025 physician fee schedule final rule | Digital therapeutics, telehealth, rural heath clinics and opioid treatment programs all got updates in the final 2025 Medicare physician fee schedule rule, (..)
Fierce Healthcare
AUGUST 2, 2024
Chutes & Ladders—Nevada BCBS Medicaid taps president; Cleveland Clinic hires AI officer; Bamboo Health brings on executives ebeavins Fri, 08/02/2024 - 09:57
Healthcare It News
OCTOBER 25, 2022
With those flexibilities due to sunset 151 days after the federal Public Health Emergency expires, HIMSS is calling on its members to contact their senators and representatives and urge them to extend coverage of telehealth services under Medicare until at least December 31, 2024.
Fierce Healthcare
NOVEMBER 1, 2023
Centers for Medicare & Medicaid Services (CMS) released a rule Wednesday that increases the 2024 home health payments by 0.8%, or $140 million. | CMS' new proposed rule will increase home health payments by 0.8%, or $140M, among other changes.
Fierce Healthcare
JANUARY 29, 2024
In 2024, 50 accountable care organizations are new to the Medicare Shared Savings Program and 71 ACOs renewed participation, according to new numbers released by Centers for Medicare & Medicaid | CMS released new data Monday showing ACO participation in the Medicare Shared Savings Program, with 19 ACOs set to participate in a new payment option, (..)
Healthcare IT Today
MAY 9, 2024
In order to get a good range of insights and opinions on what threats and opportunities health IT leaders should be looking out for, we reached out to our incredibly talented Healthcare IT Today Community while at ViVE 2024. The following video is a compilation of their answers!
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