Practice Management Update: Medicaid PCP Assignments
It has just come to our attention that a computer error is causing Medicaid patients to be delinked from their assigned PCP. In addition to the challenges posed for PCPs, our understanding is that it is also causing some claims to be denied for lack of PCP referral. …
Medicaid Audits Creating Confusion
AMS is currently addressing several complaints about audits being performed by the Arkansas Office of Medicaid Inspector General (OMIG). OMIG is a separate agency from DHS and acts independently to address Medicaid fraud, waste and abuse. AMS has received several complaints over the past month about OMIG audits…
Episodes of Care April 2016 Reports Delayed
AMS has been notified that Episodes of Care (EOC) Principle Accountable Provider quarterly reports originally scheduled for release April 29 have an anticipated publication date of June 17. For the most current information, call the APII Help Desk at 866-322-4696 or 501-301-8311; or EMAIL. During routine quality assurance…
Arkansas Works Update
On Thursday, April 21, SB 121 (including funding for Arkansas Works) was passed in the Senate then signed by Governor Asa Hutchinson. When signing, Governor Hutchinson executed the expected line item veto, extending the life of the program from an original end date of December 31, 2016 to…
CMS unveils new rules for Medicaid managed care
Article from the AMA Morning Rounds, 4/26/16. The AP (4/26, Alonso-Zaldivar) reports that on Monday, the Federal government “set new standards for Medicaid private insurance plans, which in recent years have become the main source of coverage for low-income people.” These rules impact “insurers operating as Medicaid middlemen…
Baby wait list for Medicaid mostly gone
Article by Andy Davis, Northwest Arkansas Arkansas Democratt Gazette, 3/4/2016 In the past month, the state Department of Human Services has reduced by more than half the number of infants whose applications for Medicaid have been pending more than 45 days, a department official told state lawmakers on…
Medicaid Denials for Lack of PCP Referral
The backlog in processing Medicaid enrollments has created multiple problems. AMS continues to work with DHS to address these as they come up. Some claims are being denied for lack of a PCP referral, although at the time of service the patient did not yet have a PCP.…
EHR Attestation and Hardship Exception
As announced in an earlier news alert, CMS is extending the application deadline for the Medicare EHR Incentive Program hardship exception process that reduces the burden on physicians and other providers. The new deadline for eligible professionals, eligible hospitals & CAHs is July 1, 2016. CMS is extending…
Deadline Extended for Hardship Exemption Application
New and Updated FAQs Provide Guidance on Public Health Reporting Requirements for the EHR Incentive Programs The Centers for Medicare & Medicaid Services (CMS) is extending the application deadline for the Medicare EHR Incentive Program hardship exception process that reduces burden on clinicians, hospitals, and critical access hospitals (CAHs). The new deadline…
Avoid meaningful use penalties: Exemption deadline now July 1
Physicians now have until July 1—an additional three months—to apply for a hardship exemption from the electronic health record (EHR) meaningful use financial penalties for the 2015 program year. Those who don’t apply could face up to a 3 percent cut in their Medicare payments in 2017 since…
Help with Submitting Documentation to Novitas
Novitas Solutions’ Medical Review Department has noticed an increase in the improper submission of documentation in response to an Additional Documentation Request (ADR) and has provided the following information to help alleviate the problem. Multiple occurrences have been identified of providers submitting redetermination forms in response to an…