Yesterday Centers for Medicare and Medicaid Services Administrator Seema Verma, held a press conference announcing the details of the Medicaid Fiscal Accountability Regulation (MFAR). This proposed rule is intended to increase transparency and would significantly alter state Medicaid program funding and supplemental payment plans for providers. In a recent fact sheet the American Hospital Association(AHA) […]
Massachusetts Imposes Restrictions on Medicaid Appeals for Deceased Applicants
Late last week, MassHealth implemented significant changes to its regulations on filing and pursuing an appeal for a Medicaid applicant who has passed away. The changes, impacting both providers and applicant’s families, place a number of hurtles in the appeal process and pave the way for MassHealth to dismiss previously proper appeals. The Board of […]
SHG Submits Comment on CMS’s Patients Over Paperwork Initiative
In June, CMS published a Request for Information soliciting public comments on ideas for regulatory, policy, practice, and procedural changes to reduce unnecessary administrative burdens for clinicians, providers, and patients pursuant to CMS’ Patients over Paperwork initiative. SHG worked with one of the nation’s largest long-term care providers to submit extensive comments addressing many administrative burdens placed […]
Texas on the Verge of Change: CMS Finds State is not in Compliance with Post Eligibility Treatment of Income
The Administrator of the Centers for Medicare & Medicaid Services (CMS) has found that the Texas Health and Human Service Commission (THHSC) is not properly calculating the post-eligiblity treatment of income (PETI) for institutionalized individuals and certain participants in home and community-based services (HCBS) waivers. If CMS’s finding is upheld, Texas will be required to […]
Resident’s Rights on the Verge of Major Breakthrough in Texas
A Texas resident’s right to deduct incurred medical expenses is on the verge of a major breakthrough in Texas. For years, the Texas Health and Human Services Commission (“THHSC”) has failed to recognize well-settled Federal law regarding a resident’s right to apply their patient liability toward uncovered medical expenses incurred prior to qualifying for Medicaid […]