After a stall last week, the U.S. Centers for Medicare and Medicaid (CMS), according to Becker's Hospital Review (Becker's Health IT), "released a final rule Monday that includes the first major update to Medicaid managed care regulations in more than 10 years." The "1,425-page final rule CMS released Monday 'modernizes' the system, according to CMS."

The Becker's article, published 4/26, lists 5 things to know about the new regulations, including that the, "rule imposes new requirements for the medical loss ratio," that, "In May, when the rule was proposed, Jeff Meyers, president and CEO of Medicaid Health Plans, told The Hill he 'strongly encouraged CMS not to go down this route,'" that the rule, "requires states to establish a Medicaid managed care quality rating system that includes performance information on all health plans," that the rule, "establishes new standards for managed care provider networks," and that, under, "the final rule, states are prohibited from making 'pass-through' payments to healthcare providers through health plans."

Derive Healthcare is continuing to follow all updates about these regulations, and is currently assisting organizations with meeting technology and business standards for patient care and their facilities.

Please call us at (212) 363-1111, or use the form below, to contact us with any questions.

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