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…
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 -…
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…
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…
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…
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…
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…
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…
The Wall Street Journal (3/3, Peterson, Hackman, Armour, Subscription Publication) reported the House Energy and Commerce Committee is drafting legislation to reshape Medicaid that would allow states which expanded the program under the Affordable Care Act to receive Federal funding at current levels until 2020. The bill is…
CMS has announced that the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires the removal of Social Security Numbers (SSNs) from all Medicare beneficiary cards by April 2019. A new randomly generated Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on…
The Wall Street Journal (12/16, Evans, Walker, Subscription Publication) reported that the Obama Administration has scrapped a controversial plan to alter how Medicare reimburses physicians for Part B drugs which they administer in their offices after the industry strongly criticized the proposal. Acting CMS Administrator Andy Slavitt said…