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Viewing:  Aug 24, 2019

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Medicaid Articles

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HHS Proposes Significant Changes to Patient Access Rules


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 ...

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Medi-Cal Coverage Criteria for Hospital Beds and Accessories


Medi-Cal coverage of child and adult hospital beds and accessaries. What is covered and what documentation is required.

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Wolters Kluwer Drug Pricing


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...

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Provider-Based Facilities and Split Billing: Is Your Facility Being Reimbursed for All Work Performed?


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 ...

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Dual Medicare-Medicaid Billing Problems


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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