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Regulations

Regulations

Program 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

Regulations

CMS 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

Regulations

MLTC 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

Regulations

Medicare 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

Regulations

DOH 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

Regulations

MLTC 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

Regulations

Changes to SNF Advance Beneficiary Notice of Non-Coverage

Providers are required to use the new form starting May 7, 2018.

April 30, 2018

Regulations

DOH 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

Regulations

CMS 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

Regulations

DOH 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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