CMS has issued guidance to Medicaid programs about implementing required restrictions on the state-directed payments (SDPs) made through Medicaid managed care organizations (MCOs). The budget reconciliation law known as the One Big Beautiful Bill Act (OBBBA) includes a provision that all SDPs submitted after July 4 for hospitals must be limited to the Medicare rate… The post CMS gives updates on upcoming Medicaid state-directed payment limits appeared first on HFMA.| HFMA
Republican-led appropriations committees in both chambers of Congress recently published HHS budget proposals for FY26, revealing differences both with each other and relative to a blueprint put out earlier this year by the White House. Of the three drafts, the White House recommends the biggest cuts to HHS, from $126 billion in FY25 ($113 billion… The post Senate, House release diverging HHS budget proposals for FY26 appeared first on HFMA.| HFMA
HFMA presents a detailed summary of the final rule updating the Medicare hospice payment rates, wage index, and Hospice Quality Reporting Program for FY 2026. The post FY 2026 Hospice Payment Rate Update Final Rule Summary appeared first on HFMA.| HFMA
Preventing unnecessary care and medication prescriptions is the primary purpose of prior authorization. Instead, it has all too often led to slower,| Behavioral Health Business
Behavioral health providers in one state have come out on top in a battle to remove prior authorization requirements for opioid use disorder (OUD)| Behavioral Health Business
UnitedHealth Group (NYSE: UNH) is the latest health care payer to highlight the impact of skyrocketing behavioral health utilization. Specifically,| Behavioral Health Business
Arlington, Va. — The American Chiropractic Association (ACA) has updated its coding guidance for doctors of chiropractic when providing evaluation and management (E/M) services on the same date as chiropractic manipulative treatment (CMT). ACA’s white paper on the topic, available to members on the ACA website, provides not only added clarity, but also includes scenarios [...] Read More... The post ACA Updates Coding Guidance for Evaluation and Management on Same Day as CMT appeared first...| ACA Today
Stymied Medicaid reimbursement for nursing home room and board could threaten access to care for hospice patients in California and possibly other states.| Hospice News
The hotly contested One Big Beautiful Bill Act was passed by the U.S. House of Representatives for a second and final time with a vote of 218–214. It will| Behavioral Health Business
Since the COVID-19 pandemic, there has been a significant increase in the number of individuals seeking behavioral health services. The increase in| Behavioral Health Business
New data from the federal government found that only a slim majority of behavioral health providers are able to take on new patients covered by Medicare| Behavioral Health Business
The AHA’s new Costs of Caring report highlights how hospitals and health systems continue to experience significant financial pressures that challenge their ability to provide 24/7 care for patients and communities.| American Hospital Association | AHA News
This is an exclusive BHB+ story Medicaid faces potential cuts after the Republican-led Congress passed a budget resolution to slash the outlays overseen| Behavioral Health Business
The University maintains an Accountable Plan which allows an employer (the University) to reimburse employees on a non-taxable basis when certain requirements are met. These regulations relate to reimbursing employees for business expenses, where reimbursement is not counted as income. This reimb...| University of North Carolina at Chapel Hill - Knowledge Base