Medicaid Implements “Preventable Condition” Rule
Effective July 1, 2012, Arkansas Medicaid will be implementing 42 CFR 477.26 (c)(1); which requires that all state Medicaid plans prohibit payment for "provider-preventable conditions." The umbrella term "provider-preventable conditions" (PPCs) includes two separate categories: "healthcare-acquired conditions" (HCACs) and "other provider-preventable condition" (OPPC). HCACs apply to Medicaid inpatient…
CPCI Application Period Open Now
Primary care practices considering applying for the Comprehensive Primary Care Initiative pilot program have until July 20 to submit applications. AMS has learned that currently there are approximately 84 clinics that have begun the process of application. The first step for interested practices is to complete the short…
Medicaid Releases Episode Thresholds
The Arkansas Medicaid program has released the cost threshold targets for its initial set of treatment episodes under the episode of care payment model. Those thresholds are: Non-specific Acute Ambulatory Upper Respiratory Infection $46-67 Acute Pharyngitis $60 - $80 Acute Sinusitis $68 - $87 Perinatal Care $3394 -…
US Supreme Court Upholds Mandate
On Thursday, June 28, the US Supreme Court issued its much anticipated ruling on the Obama health reform law. In a 5-4 decision the Court upheld the controversial individual mandate while negating a provision related to the Medicaid expansion. The Court ruled that Congress can enact laws that…