New guidance clarifies peer-run organizations

Feeling Overwhelmed By Medicaid Regulations? Discover a Streamlined Approach. Optimizing your practice for Medicaid regulations can be a time-consuming challenge. Strict adherence is crucial to avoid financial penalties, lost reimbursements, and even exclusion from the program. However, navigating the complexities of Medicaid compliance can detract from your ability to deliver exceptional patient care. This is where Smart Compliance Solutions come in. These innovative tools offer a comprehensive approach to streamlining compliance processes within your practice. Here's how they can benefit you: Enhanced Accuracy and Efficiency: Automate tasks like eligibility verification and coding to minimize errors and ensure accurate claims submission. Proactive Problem Management: Receive real-time audit alerts to identify potential areas of non-compliance before they lead to claim denials. Staying Informed: Benefit from built-in regulatory updates and guidance, ensuring your practice remains compliant with evolving Medicaid regulations. Empower Your Practice with Smart Compliance. Read our blog post to delve deeper into the advantages of Smart Compliance Solutions and how they can enable your practice to thrive: https://lnkd.in/gsVVTZHN #MedicaidRegulation #MedicalCompliance #HealthFutuNearSociety

Some Ohio Medicaid stats from SFY 2018 to SFY 2024: Total state share for services grew 32% SFY 2018: $3,725,608,590 SFY 2024: $4,908,890,299 Change: $1,183,281,709 Tot admin expenditures grew by 25% SFY 2018: $925,770,867 SFY 2024: $1,157,983,318 Change: $232,212,451 The number of people enrolled grew by 5% SFY 2018: 2,938,399 SFY 2024: 3,072,882 Change: 134,483 This change is a little misleading because of redeterminations. If the highest enrollment for the SFY is used, it would be a 18% increase in the number of people enrolled. Source: https://lnkd.in/gnQWUVbh

There's still time to register for today's #webinar at 2:00 pm ET. Key takeaways include examining the differences between #Medicare and #Medicaid and how each can impact settlements, reviewing how #lien processes differ between Medicare and Medicaid, and discussing #FutureMedicalAllocations. Register now at https://lnkd.in/gZ2NF-7c. #MSPcompliance #LienResolution

Maintaining compliance with #Medicaid calculation and reporting requirements is essential to protecting your business and brand. Learn about #ModelN's Medicaid solution, which enables you to efficiently comply with all government rebate calculation and reporting requirements, operationalize the end-to-end Medicaid rebate process, and access key insights to drive strategic decisions: https://lnkd.in/eRcs5BiZ #LifeSciences #RevenueOptimization #RevenueManagement #Compliance

I’m following Stabilize #Medicaid and #CHIP Coverage Act (H.R. 5434 and S. 3138) closely. Consistent, comprehensive coverage is critical for overall health and I’m curious to see what traction we’ll see this #Congress… https://lnkd.in/gvCWaqVC

Today, a client approached me concerning a significant concern: a noticeable drop in rates after terminating our services. Understanding the complexity behind this issue, the client requested a detailed analysis from our team. It's crucial for SNFs and owners to recognize the potential complacency that can arise, assuming services are effective and rates are optimal. Often, the intricacies of our daily work are overlooked, where we diligently strive to maximize Medicare and Medicaid services for facilities in real-time while ensuring strict compliance. It's imperative to remain proactive and vigilant in navigating these challenging dynamics. #Medicare #Medicaid #Compliance #HealthcareServices

Is your MCO losing money without you realizing it? Learn how to identify and fix these leaks at our August webinar. Agilian’s experts will provide actionable insights to help you plug these revenue leaks. 🔗 Register Here -> https://hubs.ly/Q02Kv3Cj0 #HealthCareManagement #RevenueRecovery #Medicaid #MCO #Webinar

CMS released a final rule updating Medicare programs like Medicare Advantage, Medicare Part D, and PACE. The changes aim to improve protections, competition, and service, expand behavioral health care access, promote coverage equity, and enhance supplemental benefits. Check it out: https://zurl.co/1ofU #MedicareAdvantage #Medicaid

The quest to optimize Medicaid budgets will never end for state programs and MCOs, but now, programs are pulling more data into the equation. We sat down with SKYGEN's Clinical Director of Benefits Management, Dr. Shirley Ann Spater DMD, MPH, FADPD, DABSCD, to talk about our use of data in collaborating with Medicaid clients to increase preventive care and continuity of care, especially among the most vulnerable. 🔗 Read our new blog! https://lnkd.in/gbzryKna #Medicaid #OralHealthEquity

💬 Confused about Medicaid’s “Medically Needy” program in Connecticut? This program may help your loved one qualify for benefits even if their income is above the limit. Let’s chat about your options. #MedicaidCT #Title19 #ElderCarePlanning