Connect Archives

April 2017

Tuesday, April 25, 2017

CMS PROPOSES 2018 PAYMENT AND POLICY UPDATES FOR MEDICARE HOSPITAL ADMISSIONS, RELEASES A REQUEST FOR INFORMATION

On April 14, CMS issued a proposed rule that would update 2018 Medicare payment and polices when patients are admitted into hospitals. The proposed rule aims to relieve regulatory burdens for providers; supports the patient-doctor relationship in health care; and promotes transparency, flexibility, and innovation in the delivery of care.

CMS is proposing:
• a one year regulatory moratorium on the payment policy threshold for patient admissions in long-term care hospitals while CMS continues to evaluate long-term care hospital policies
• to reduce clinical quality measure reporting requirements for hospitals that have implemented electronic health records

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AHCA ANNOUNCES START OF RE-PROCUREMENT PROCESS FOR STATEWIDE MEDICAID MANAGED CARE PROGRAM

Most Florida Medicaid recipients are enrolled in the Statewide Medicaid Managed Care (SMMC) Program. The Agency for Health Care Administration (AHCA) is responsible for administering the SMMC program and re-procuring health plans every five years. The SMMC program has two components, the Long-term Care (LTC) program and the Managed Medical Assistance (MMA) program. AHCA is in the process of developing the Invitation to Negotiate (ITN) to re-procure health plans for the SMMC program. This will be the first re-procurement since the program began in 2013. The ITN will be released in summer of 2017.

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MEDICAID TO ALLOW REIMBURSEMENT FOR A WELL-CHILD VISIT AND SICK VISIT ON THE SAME DAY

The Agency for Health Care Administration has updated its Medicaid policies to allow reimbursement for a well-child visit (Child Health Check-up) and a sick visit on the same day, in accordance with the guidelines published in the American Medical Association Current Procedural Terminology (CPT) code book.

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WELLCARE’S MEDICARE 2017 PARTNERSHIP FOR QUALITY PROGRAM

WellCare Health Plan values the quality of health care delivered to its members. The Partnership for Quality Program (P4Q) recognizes providers who collaborate to deliver and appropriately document quality care. The program incorporates HEDIS, Continuity of Care and Pharmacy measures into a singular, comprehensive program.

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HFNI PROFESSIONAL LIABILITY INSURANCE PROGRAM.

Health First Network, Inc. (HFNI) has formed the HFNI Professional Liability Insurance Program, a program designed to enhance the professional liability coverage of our members with available discounts of up to 50% for qualified members.

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HFNI WORKERS COMPENSATION INSURANCE PROGRAM

Did you receive money back on your Workers’ Comp Premium last year? Now you are eligible through the Health First Network Workers’ Compensation Program.

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NEW PHYSICIANS JOINING THE NETWORK

Health First Network would like to welcome the most recent physicians to join the Network:
Erica Thomson, M.D. Hospitalist
James Reynolds, M.D. OB/GYN
David Lalli, D.O. Orthopaedic Surgery
Robert Farr, M.D. Internal Medicine (Aids/HIV only)
Michael Dent, M.D. Dermatology
David Dean, D.O. Orthopaedic Surgery
Jane Cook, D.O. Radiology
Melanie Thomas, M.D. Endocrinology, Diabetes and Metabolism
Joseph Cahill, M.D. Neurology

** To determine which health plans each physician is participating in check the “Find A Doctor” section on the HFNI website.

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