Change Healthcare Network Disruption
According to UnitedHealth's filing with the U.S. Securities and Exchange Commission on Thursday, the attack on Change Healthcare is believed to be linked to a "suspected nation-state-associated" actor. The company swiftly took action upon detection, isolating and...
MHC and MFT Medicare Enrollment Standards
MFT's are eligible to enroll in the Medicare program effective January 1, 2024. As MFT's consider enrolling in the Medicare program, it is important to understand the enrollment standards required. This article summarizes the Medicare Program Integrity manual that...
Medicare Provider Enrollment Changes for 2024
There are significant changes in the Medicare Provider Enrollment process that will take effect for 2024. Outlined below are key regulatory updates set to take effect on January 1, 2024, that providers and suppliers should be cognizant of due to their significant...
AZ Medicaid Extends Enrollment Moratorium for Behavioral Health
The Arizona Health Care Cost Containment System (AHCCCS) announced an extension of the statewide moratorium on the enrollment of Behavioral Health Outpatient Clinic, Integrated Clinic, Non-Emergency Medical Transportation, Community Service Agencies, and Behavioral...
Massachusetts Removes Invasive Credentialing Questions for Healthcare Practitioners
Massachusetts healthcare organizations have announced a groundbreaking initiative to eliminate "stigmatizing or invasive" mental health questions from physician credentialing processes in every hospital, health system, and local health plan in the state. This move,...
What is a CP575
The CP575, also known as the Employer Identification Number (EIN) Assignment Notice, is a crucial document issued by the Internal Revenue Service (IRS) in the United States. This notice serves as confirmation of the assigned EIN for businesses and other entities for...
Medicare Application Fee CY 2024
Effective January 1, the application fee is $709 for institutional providers who are: Initially enrolling in the Medicare or Medicaid programs or the Children's Health Insurance Program (CHIP) Revalidating their Medicare, Medicaid, or CHIP enrollment Adding a new...
Oklahoma Medicaid Program To Begin Using MCO’s
The Oklahoma Health Care Authority (OHCA) has chosen three Managed Care Organizations (MCO's) also referred to as "Contracted Entities (CE)", Aetna Better Health of Oklahoma, Humana Healthy Horizons of Oklahoma, and Oklahoma Complete Health (a Centene Corporation...
Ohio Medicaid Resumes Provider Revalidation Process – What Providers Need to Know
The Ohio Department of Medicaid (ODM) has recently resumed the provider revalidation process, marking a crucial step in the federally mandated unwinding process from the COVID-19 public health emergency. In a press release, ODM outlined the timeline and essential...
CMS 2024 Physician Payment Rule with new Practitioner Types
The Centers for Medicare & Medicaid Services (CMS) has finalized policies in the calendar year 2024 Medicare Physician Fee Schedule (PFS) to enhance primary care, promote health equity, support family caregivers, and expand access to behavioral and certain oral...
Anthem BCBS Georgia Publishes Notice of Practitioner’s Rights During The Credentialing Process
In a newsletter from Anthem Georgia, the payor disclosed a list of rights that all practitioners have during the credentialing process: As part of our credentialing process, practitioners have certain rights as briefly outlined below. Practitioners can request to:...
PA Medicaid Clears Backlog of Provider Enrollment Applications
During his first month in office, Pennsylvania Governor Josh Shapiro signed an Executive Order directing all state agencies to compile a catalog of the licenses, certificates, and permits they administer – including the length of time it takes them to process...
