On April 15th, 2022, the Departments of Health and Human Services (HHS), Labor, and the Treasury launched the federal Independent Dispute Resolution (IDR) portal for providers, facilities, and air ambulance services, as well as group health plans and health insurance issuers to facilitate the federal IDR process for items and services subject to the surprise …
H.R.3630 – The No Surprises Act Has Come With A Few Surprises Read More »
The leaves are beginning to turn colors and Medicare open enrollment for 2023 is upon us…. Meaning, Medicare Advantage planning for 2024 is right around the corner – YES, 2014! While current Medicare Advantage (MA) plans are preparing for open enrollment to begin, future planning for the upcoming 2024 initial and service area expansions are …
Medicare 2024 is Coming… Have You Started Your Strategic Plan? Read More »
On June 17, 2020, Medicare Advantage Plans (Part C) received a break in Network Adequacy requirements for 2021 provider network filings. The updated rules reduce requirements for several key provider categories, add a 10 percent credit for using telehealth for vital provider types, and lower the time and distance requirements from 90 to 85 percent …
Strategic Planning prior to provider network development is often the last thing on executive’s minds. When going into a new, or expanding on current markets, there never appears to be enough time, or money, to take this essential step. While most managed care organizations have a simple project plan covering most of the ins-and-outs of …
