Medicare & Medicaid
From the AMA: Medicare Physician Payment System On the Brink
Congressional inaction on the Medicare physician payment system in the “lame duck” sessionwill immediately threaten patient access to physician care. Medicare beneficiaries' access to a physician is in jeopardy due to a planned 8.42% cut in Medicare reimbursements starting January 1, 2023. Congress has historically suspended many of…
CMS Vaccination Requirements Compliance Deadline is February 14, 2022
**The following information does not apply to private physicians’ practices. On January 13, 2022, the U.S. Supreme Court upheld the Centers for Medicare & Medicaid (CMS) Health Care Staff Vaccination Standards, which gives CMS the authority to enforce its interim final rule requiring many Medicare- and Medicaid-certified providers…
Senate Passes Legislation to Halt Medicare Physician Payment Cuts
After months of intense lobbying by the American Medical Association, Arkansas Medical Society, other state medical societies, and national medical specialties, a bi-partisan agreement has been reached by Congress to halt Medicare physician payment cuts that were scheduled to take effect on January 1, 2022. President Biden is…
PCMH High Priority Beneficiary (HPB) Selection, Deadline May 31
AMS has been notified that some changes have been made to a physician's selection of high priority beneficiaries. The AHIN portal (BCBS) will reopen May 25 for physicians to reselect their PCMH HPBs for the 2018 performance period. This opportunity is due to the recent primary care provider (PCP) reassignment. It was…
New Medicare Card
Beginning in April 2018, the Centers for Medicare & Medicaid Services (CMS) will mail new Medicare cards to all people with Medicare on a flow basis by geographic location and other factors. Additional details on timing will be available as the mailings progress. Mailing Schedule April -…
PBPM Payments
AMS has learned from the Medicaid program that a capitation payment (PBPM) for Quarter 1 of 2018 was generated to PCMHs on March 10 with a settlement date of March 16 and some of those checks were paid incorrectly. According to DXC some of these PBPM payments from…
Prepare for New Medicare Cards
The new Medicare card is a result of MACRA's requirement that CMS issue Medicare cards that do not display Social Security numbers to address the risk of beneficiary identity theft. New Medicare cards will be issued beginning in April 2018 and physician offices must be prepared to accept…
Enhancements to Medicaid Management Information System (MMIS)
After receiving a number of calls about concerns regarding the new Medicaid Management Information System (MMIS) portal, AMS recently met with representatives of DXC, DHS and AFMC to discuss the complaints. Those complaints include lack of eligibility information, PCP assignment and remittance advice information. Below are the enhancements that…
ABCBS Reduces Reimbursement for Individual Market Plans
AMS has learned that the state's largest insurance carrier, Arkansas Blue Cross and Blue Shield will reduce reimbursements to its provider network effective January 1, 2018. The reduction applies only to the carrier's individual metallic health plans (i.e. not group health plans), which include the Arkansas Works Medicaid…
Arkansas’ Upgrade to a New Medicaid Management Information System
New MMIS Healthcare Portal Official Go-live Date is November 1, 2017. This is the new way claims will transmitted to Medicaid. In preparation for this transition, many activities leading up to November 1 will be taking place. Learn more in the October issue of the ARMedicaid Insider. The issue…
Republicans release modified version of health care bill
USA Today (3/20, Groppe) reports that Republicans released a modified bill Monday night “in an attempt to shore up support among both conservatives and moderates.” The revised bill would allow states “to require able-bodied Medicaid recipients without dependents to work beginning in October.” In addition, “states could receive…