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CMS Final Rule regarding Medicare Advantage Plans

On April 5, 2023, the Centers for Medicare and Medicaid Services (“CMS”) issued a final rule for Medicare Advantage (“MA”) Plans, confirming that MA Plans must follow the 2-Midnight Rule, its case-by-case exception, the inpatient-only (“IPO”) list, as well as traditional Medicare coverage criteria.

Stop, Drop and Reenroll: How Medicaid Redeterminations, Renewals, and Disenrollment Can Affect the Revenue Cycle

When Congress enacted the Families First Coronavirus Response Act as a response to the COVID-19 Public Health Emergency Declaration (“COVID PHE”), it provided for a significant increase in federal funding for Medicaid and Children’s Health Insurance Programs on the condition that such programs provide for automatic reenrollment throughout the Public Health Emergency period and for one month after.