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CMS Revises Fiscal Year (FY) 2023 State Performance Standards System (SPSS) Guidance

Briggs Healthcare

The SPSS is aligned with CMS expectations for State Survey Agency performance in accordance with the §1864 Agreement and all related regulations and policies intended to protect and improve the health and safety of Americans such as the State Operations Manual, the Mission and Priority Document, survey procedure guides, and other relevant documents.

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HCPCS vs CPT: Everything You Need to Know

Etactics

However, Medicare and other insurance cover a variety of different services and supplies, some of which aren’t identified by CPT codes. These codes assist healthcare workers in reporting different medical procedures and services to health insurance programs, such as Medicare and Medicaid. H Codes - Rehabilitative services.

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NAHC’s Bill Dombi: Horizontal Integration, Workforce Innovation to Accelerate in 2022

Home Health Care

The end of 2021 brought a handful of key home health policy issues to a temporary conclusion, including the congressionally secured delay to Medicare sequestration. One of the most recent ones is Medicare sequestration. Because it’s again, delaying that 2% Medicare sequestration cut, but also PAYGO requirements as well. [00:01:27]

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National Care Coordination Standards for Children and Youth with Special Health Care Needs (CYSHCN): Proceedings from the National Forum on Care Coordination for CYSHCN

NASHP

High-quality, integrated care requires strong system-level partnerships, information and data sharing, and family-centered practices. In spite of these barriers, and to help address them, states have implemented innovations to improve integrated care coordination for CYSHCN.

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Behavioral Health System Modernization along the Continuum

NASHP

North Carolina’s comprehensive behavioral health approach included efforts to increase uptake of CoCM through additional training and practice supports and Medicaid rate increases to 120% of Medicare rates for behavioral health providers. An action plan dashboard tracks targets. CMS’s Birth to 5: Watch Me Thrive!

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CMS Promotes Competition, Transparency, Health Equity and More in the CY2025 Medicare Advantage and Part D Proposed Rule

Sheppard Health Law

On November 6, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released the contract year 2025 proposed rule for Medicare Advantage (“MA”) organizations and Part D sponsors (the “Proposed Rule”). The UM committee was established in April 2023 in the 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F).