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...
New Medicare Benefit Category
Beginning January 1, 2024 the Consolidated Appropriations Act, 2023 (CCA, 2023) establishes a new Medicare benefit category for mental health services. As early as Q4 2023, qualified MFT and MHC practitioners can begin enrolling in the Medicare program. The effective...
Iowa Medicaid Updates Provider Enrollment System
HHS Technology Group, LLC (HTG) has partnered with Noridian Healthcare Solutions, LLC and the Iowa Department of Health and Human Services to enhance Iowa's Medicaid provider management system. The partnership will implement HTG's Discover your Provider (DyP)...
Humana Exits Employer Group Commercial Medical Insurance
Humana Inc. made an important announcement today regarding its future business focus. The company has decided to discontinue its involvement in the Employer Group Commercial Medical Products business, which includes various medical plans such as fully insured,...
GA Governor Signs Law Banning ‘Medical Title Misappropriation’
Governor Brian P. Kemp of Georgia has signed a new law that will come into effect on July 1st, which requires medical specialists to have proper credentials to support their claims. Georgia Senate Bill 197, known as the "Health Care Practitioners Truth and...
Optum to Manage Provider Enrollment for NC Medicaid
Optum selected to oversee the enrollment, credentialing, and data management for more than 90,000 healthcare providers serving patients in the state’s public health programs.
Health Data Privacy & Telehealth
In response to the increased utilization of telehealth due to the COVID-19 pandemic, there has been growing concern over how telehealth vendors and practitioners protect and use health data. Policymakers and regulators have proposed or implemented policies to address...
