RegulationsProgram Integrity Reports Due
Medicaid managed care plans are required to file the annual Program Integrity Report through the Health Commerce System by Jan. 31st.
- January 18, 2019
RegulationsCMS Proposes New Medicaid Managed Care Regulations
The proposed regulations are intended to reduce administrative burdens and give state Medicaid agencies greater flexibility to address local circumstances and populations.
- November 13, 2018
RegulationsMLTC Lock-in Policy, Change in NH Benefit Await CMS Action
State’s letter to CMS, draft member notices are posted on DOH website.
- October 29, 2018
RegulationsMedicare Advantage Proposal Aims for Flexibility
Proposed Medicare Advantage rule seeks to expand telehealth, coordinate processes for those eligible for Medicare and Medicaid.
- October 26, 2018
RegulationsDOH Webinar Describes VBP Tracking Process for MLTC Plans
DOH hosted a webinar last week for MLTC plans to provide instructions for submission of the Value-Based Payment Tracking Report.
- July 17, 2018
RegulationsMLTC High Cost High Need Survey
DOH is requesting that all MLTC plans submit detailed information on High Cost High Need members by June 29, 2018.
- May 21, 2018
RegulationsChanges to SNF Advance Beneficiary Notice of Non-Coverage
Providers are required to use the new form starting May 7, 2018.
- April 30, 2018
RegulationsDOH Provides Details of New Managed Care Appeals, Fair Hearing, and "Aid Continuing" Procedures
DOH provided additional detail about new managed care appeals, fair hearing, and "aid continuing" procedures in an April 13th webinar.
- April 24, 2018
RegulationsCMS Final Rule Available
An advance copy of the 2019 Medicare Advantage Program and Prescription Drug Benefit Program Final Rule has been posted to the CMS website.
- April 3, 2018
RegulationsDOH Webinar Describes Changes in Managed Care Authorization, Appeals, and Fair Hearing Procedures
Effective May 1st, new federal regulations provide for different times frames and procedures for authorizations, appeals, fair hearings, and complaints.
- April 3, 2018
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