U.S. Health Officials Seek New Curbs on Private Medicare Advantage Plans
Proposed regulations would crack down on misleading ads for the private plans and would enhance scrutiny of denials for coverage of medical care. (Source: NYT Health)
Source: NYT Health - December 17, 2022 Category: Consumer Health News Authors: Reed Abelson and Margot Sanger-Katz Tags: Medicare Health Insurance and Managed Care Medicare Advantage Centers for Medicare and Medicaid Services Source Type: news

I want my brother to move out of our inherited home
Dear Newsweek, I'm a 54-year-old female on the autistic spectrum. I work part-time and have a difficult time keeping a job, but I try my best. I also have mental health issues. I share a house with my older half-brother, he is 64, and had a traumatic brain injury from a car accident three and a…#whatshouldido #dearnewsweek #biancapadilla #supplementalsecurityincome #miami #medicaid #americanswithdisabilitiesactnational #nationalfamilycaregiversupportprogra #wendyoneill #carewell (Source: Reuters: Health)
Source: Reuters: Health - December 17, 2022 Category: Consumer Health News Source Type: news

CMS delays decision on amyloid PET coverage
The U.S. Centers for Medicare and Medicaid Services (CMS) plans to take mor...Read more on AuntMinnie.comRelated Reading: CMS rethinks limit on PET scans for Alzheimer’s disease patients CMS criticized for final decision on Aduhelm reimbursement CMS finalizes rule on limited payment for Alzheimer's drugs CMS to limit coverage of new drugs for Alzheimer's disease SNMMI pushes for coverage of PET tracers for Aduhelm use (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - December 16, 2022 Category: Radiology Source Type: news

Triangle doctor to pay $385K to settle fraud claim
A Triangle OB/GYN practice and its owner are paying $385,000 to settle allegations of Medicaid fraud. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - December 16, 2022 Category: Pharmaceuticals Authors: Lauren Ohnesorge Source Type: news

CMS: Membership List and Meeting Dates for the Ground Ambulance and Patient Billing (GAPB) Advisory Committee, January 17-18, 2023
The Centers for Medicare& Medicaid Services (CMS) announces the membership of the Ground Ambulance and Patient Billing (GAPB) Advisory Committee and provides notice of its first virtual public meeting to be held on January 17-18, 2023. The agenda includes an overview of the No Surprises Act, and information on the ground ambulance industry, insurance and payment systems, billing practices, and the impact of balance billing on consumers, among other things. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 16, 2022 Category: Rural Health Source Type: news

Centene to pay $44.4 million to settle latest PBM allegations
So far, Centene has reached settlements that have been announced by at least 12 states, requiring the nation's largest Medicaid managed care provider to make about $552.4 million in payments. Centene last year set aside $1.1 billion to resolve allegations from states. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - December 15, 2022 Category: Biotechnology Authors: James Drew Source Type: news

Grant Funding for Medicaid Home and Community-Based Services Tops $17 Million
Today the Wisconsin Department of Health Services (DHS) announces the final 26 awardees for the Medicaid home and community-based services (HCBS)grant opportunity. A total of $17.3 million for 69 organizations will fund activities that improve services for people who are older or have a disability, helping them remain in their home or community. Previously, DHS announced theinitial $12 million in funding for...(see release) (Source: Wisconsin DHFS Press Releases)
Source: Wisconsin DHFS Press Releases - December 15, 2022 Category: Hospital Management Authors: millejcodn Source Type: news

Grant Funding for Medicaid Home and Community-Based Services Tops $17 Million
Today the Wisconsin Department of Health Services (DHS) announces the final 26 awardees for the Medicaid home and community-based services (HCBS) grant opportunity. A total of $17.3 million for 69 organizations will fund activities that improve services for people who are older or have a disability, helping them remain in their home or community. Previously, DHS announced the initial $12 million in funding for 43 organizations. The additional $5.3 million in awards marks the completion of the...(see release)JenniferC.MillerDecember 15, 2022 (Source: Wisconsin DHFS Press Releases)
Source: Wisconsin DHFS Press Releases - December 15, 2022 Category: Hospital Management Authors: JenniferC.Miller Source Type: news

Public Inspection: HHS, CMS: Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2024
Pre-publication notice of proposed rule from the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) proposing payment parameters and provisions related to the risk adjustment and risk adjustment data validation programs and user fees for Federally-facilitated Exchanges and State-based Exchanges on the Federal platform, among other things. Comments are due by January 30, 2023. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 15, 2022 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, Medicare Parts A, B, C, and D Overpayment Provisions of the Affordable Care Act and Programs of All-Inclusive Care for the Elderly; Health Information Technology Standards and Implementation Specifications
Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services to amend regulations for Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE), among other things. Comments on the proposed changes are due February 13, 2023. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 15, 2022 Category: Rural Health Source Type: news

CMS: Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare and Medicaid Services is seeking comment on the following information collections: 1) Annual Eligibility Redetermination, Product Discontinuation and Renewal Notice; 2) Medicare Advantage and Prescription Drug Program: Final Marketing Provisions in 42 CFR 422.111(a)(3) and 423.128(a)(3); 3) Medicare Plan Performance Warning Information; and 4) Medicare Enrollment Application for Institutional Providers. Comments are due February 13, 2023. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 15, 2022 Category: Rural Health Source Type: news

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request
The Centers for Medicare and Medicaid Services is seeking comment on the following information collections: 1) Physician Certifications/Recertifications in Skilled Nursing Facilities Manual Instruction, which requires a physician to certify a Medicare beneficiary's need for posthospital skilled nursing facility services; and 2) Notice of Denial of Medicare Prescription Drug Coverage. Comments are due by January 17, 2023. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 15, 2022 Category: Rural Health Source Type: news

New Delta Dental Institute survey indicates that almost half of U.S. adults cite inflation among top concerns for delaying or canceling dental cleanings since 2021
Survey also found that adding dental coverage to Medicare and Medicaid has bipartisan support WASHINGTON, Dec. 7, 2022 /PRNewswire/ -- New public opinion research released today from the Delta Dental Institute found that U.S. adults were more likely to report that concerns about inflation and rising prices, rather than concerns about COVID-19, prompted them to delay oral health care. Delta Dental Institute (PRNewsfoto/Delta Dental Institute) The poll found that 95% of adults agree oral health is essential to overall health. Almost 6 in 10 said they would continue to receive routine, preventive dental care to avoid major he...
Source: Dental Technology Blog - December 14, 2022 Category: Dentistry Source Type: news

Funding, Policy Changes Needed to End Maternal Health Crisis, Federal Officials Say
(MedPage Today) -- WASHINGTON -- Addressing the maternal mortality crisis requires a layered approach that includes extending Medicaid coverage for postpartum persons, expanding home visitation programs, and giving hospitals "gold stars," government... (Source: MedPage Today OB/GYN)
Source: MedPage Today OB/GYN - December 14, 2022 Category: OBGYN Source Type: news

Public Inspection: CMS: Meetings: Membership List and Meeting Dates for the Ground Ambulance and Patient Billing Advisory Committee
The Centers for Medicare and Medicaid Services (CMS) announces the membership of the Ground Ambulance and Patient Billing (GAPB) Advisory Committee and provides notice of its first virtual public meeting to be held on January 17-18, 2023. The agenda includes an overview of the No Surprises Act, and information on the ground ambulance industry, insurance and payment systems, billing practices, and the impact of balance billing on consumers, among other things. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 14, 2022 Category: Rural Health Source Type: news