Medicaid Articles and Resources
News and Important Information
Select the title to see a summary and a link to the full article.
February 11th, 2019
HHS Proposes Significant Changes to Patient Access Rules
Published February 11th, 2019|
In a significant announcement on February 11, 2019, HHS proposed new rules aimed at improving interoperability of electronic health information. This announcement was made in support of the MyHealthEData initiative which was announced by the Trump administration on March 6, 2018. The goal of that initiative was to break down ...
November 7th, 2018
Medi-Cal Coverage Criteria for Hospital Beds and Accessories
Published November 7th, 2018|
Medi-Cal coverage of child and adult hospital beds and accessaries. What is covered and what documentation is required.
October 17th, 2018
Wolters Kluwer Drug Pricing
Published October 17th, 2018|
Wolters Kluwer provides unit and package pricing for multiple drug price types: Average Wholesale Price (AWP), Wholesale Acquisition Cost (WAC), Direct Price (DP), Manufacturer's Suggested Wholesale Price (SWP), Centers for Medicare & Medicaid Services, Federal Upper Limit (CMS FUL), Average Average Wholesale Price (AAWP), Generic Equivalent Average Price (GEAP). Average...
July 18th, 2018
Provider-Based Facilities and Split Billing: Is Your Facility Being Reimbursed for All Work Performed?
Published July 18th, 2018|
Are you stumped by billing guidelines for provider-based facilities? Who bills for what and why? Read on to hear how a little extra time and effort spent on researching split billing coding guidelines can greatly impact your facility, and even your budget ensuring reimbursement for all services performed. For ...
July 12th, 2018
Dual Medicare-Medicaid Billing Problems
Published July 12th, 2018|
It is important to keep in mind that Medicaid is run at a state level so there can be some differences when it comes to coverage. However, the rules regarding balance billing of covered services is set at the federal level. The law states (emphasis added): A state plan must provide ...
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