Providers

On August 3, 2021 CMS published a proposed rule that would rescind a 2019 policy change prohibiting reassignment of certain Medicaid payments. The rule would re-instate a policy that was first established in 2014 allowing payments to third parties when Medicaid program is the primary source of revenue for the provider. CMS is accepting comment on the proposed rule until September 28, 2021.

This guide highlights the benefits and opportunities available for CBOs interested in providing services under Medicare FFS. It describes important considerations including billing and filing processes, culture change, and regulatory compliance. The guide also reviews how to enroll as a Medicare provider and outlines which services CBOs can offer.

The Health Resources & Services Administration released a fact sheet that details how Medicaid and CHIP providers can obtain payment from the Provider Relief Fund. In June, HHS announced approximately $15 billion from the Provider Relief Fund would be distributed to eligible state Medicaid and CHIP providers. The fact sheet includes eligibility requirements and suggestions on how providers can utilize funds for COVID-19-related expenses.

As part of Mathematica’s ongoing evaluation project of section 1115 demonstrations, they have released their interim findings on the DSRIP program. This report shows quantitative evidence of DSRIP motivating positive provider actions, but the program’s impact on outcomes is still unclear. Mathematica aims to release a final report on the effectiveness of DSRIP in 2019.

The historical progression of bundled payments from acute care to post-acute care and the growing recognition of the value of HCBS create an interesting opportunity for sustainably integrating medical services with other (LTSS). Building on past lessons from efforts to incorporate community-based LTSS into traditional medical care models, such as care transitions, may help to inform successful future strategies to enable bundles to more efficiently achieve the Triple Aim.

The National Center for Health Statistics (NCHS) has four new reports available from the National Study of Long-Term Care Providers (NSLTCP). The data briefs and state tables use survey data from NCHS’ 2014 NSLTCP. NSLTCP provides reliable, accurate, relevant, and timely statistical information to support and inform long-term care services policy, research, and practice.

The Integrated Care Resource Center released a brief that offers tips for engaging providers in integrated care programs for Medicare-Medicaid enrollees. Integrated care programs are successful when a broad spectrum of providers are engaged in the process. This brief provides states with tips on how to engage physicians, hospitals, nursing facilities, and community-based service providers that serve Medicare and Medicaid enrollees.