CMS To End Advance-Payment Program For Those Affected By Hack
The program, launched in March in the aftermath of the Change Healthcare cyberattack, sent advance payments to providers whose operations were disrupted. CMS also announced a do-over of 2024 quality scores for Medicare Advantage plans.
Reuters:
US To Stop Advance Payments For Medicare Providers Hit By Change Hack
The Centers for Medicare and Medicaid Services said on Monday it plans to close the advance payments program it started to help some Medicare providers and suppliers affected by disruptions at UnitedHealth's Change Healthcare technology unit. It launched the payments program in March after a hack at Change Healthcare on Feb. 21 by a group called ALPHV, also known as "BlackCat", disrupted medical insurance payments across the United States. (6/17)
Modern Healthcare:
2024 Medicare Advantage Star Ratings Revision: Winners And Losers
Medicare Advantage insurers that receive higher revised star ratings for this year stand to gain additional quality bonus payments that one analysis estimates could exceed $1 billion. The Centers for Medicare and Medicaid Services announced Thursday that it has redone 2024 quality scores for Medicare Advantage plans after years of complaints and a pair of losses in lawsuits challenging how it modified the ratings formula. Medicare Advantage contracts that earn new scores of at least 3.5 of 5 stars will get higher bonus payments this year and have more time to submit bids for 2025. (Tepper, 6/17)
In Medicaid news —
Roll Call:
Wyden Wants More Medicaid Funding To Keep Obstetric Units Open
The chair of the Senate Finance Committee on Monday released a bill that would increase federal financial support to hospitals in hopes of stemming the tide of labor and delivery unit closures in rural and underserved areas. Nearly a quarter of rural hospitals stopped providing obstetric services between 2011 and 2021, according to Chartis, a health care consulting firm. Analysts blame the closures on low Medicaid reimbursement rates and declining birth rates in rural communities. The combination, they said, makes it financially challenging to keep labor and delivery units staffed. (Hellmann, 6/17)
Modern Healthcare:
CalOptima To Increase Medicaid Pay Under Managed Care Contract
CalOptima Health's board approved a $526.2 million pay bump for providers who are part of the insurer's Medicaid managed care network in Orange County, California, the county-run health insurer announced Monday. The funds will be distributed from July 2024 to December 2026 to hospitals, physicians, community clinics, behavioral health practitioners and other safety-net providers in Southern California, CalOptima said in a news release. (Kacik, 6/17)
Missouri Independent:
Federal Government To Scrutinize Missouri’s Medicaid Delays
Missouri’s delays in processing Medicaid applications — among the worst in the nation — have the attention of federal regulators, who will conduct a “focused review” of the problem, according to a letter obtained by The Independent. (Bates, 6/18)
North Carolina Health News:
'Tailored’ Medicaid Plans Launching In North Carolina
Medicaid is about to change for tens of thousands of North Carolinians who have complex health care needs. For most of the state’s 2 million-plus Medicaid beneficiaries, nothing will happen. The state plans to move about 160,000 enrollees, many of them people with intellectual or developmental disabilities, onto specialized Medicaid plans beginning July 1. These “tailored” plans are geared toward beneficiaries who require more extensive care and support than typical Medicaid participants. (Baxley, 6/18)
Axios:
Boosting Hepatitis C Treatment Would Save Money, CBO Says
Doubling the number of Medicaid enrollees receiving hepatitis C treatments would avoid about $7 billion in health care costs over a decade, according to a new Congressional Budget Office report on the burden the liver disease places on medical care and safety net programs. (Bettelheim, 6/18)
