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New York state's Medicaid Visual Data Mining System allows state officials and policy makers to track the results of savings initiatives in real time, via a spending tracking website, according to Morris Peters, a spokesperson for the Division of Budget. (To view the site, go to http://www.health.state.ny.us/health_care/medicaid/regulations/global_cap/.)
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Under a proposed rule published in May 2011 from the Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies would have to review access to a subset of Medicaid-covered services every year, and review access to every Medicaid-covered service at least once every five years.
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The Affordable Care Act (ACA) requires that state Medicaid agencies reimburse primary care providers at 100% of the Medicare fee schedule for two years, notes Donald Ross, manager of the policy and planning section at the Oregon Health Authority's Division of Medical Assistance Programs.
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A state plan amendment submitted by North Carolina Medicaid to the Centers for Medicare & Medicaid Services (CMS) to participate with the Medicaid recovery audit contractor (RAC) program has already been approved, and a request for proposal will be released shortly, reports Brad Deen, a spokesperson for North Carolina Division of Medical Assistance (NCDMA).
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A new Medicaid recovery audit contractor (RAC) program will help strengthen the integrity of the Medicaid program, according to Xiaoyi Huang, JD, assistant vice president for policy at the National Association of Public Hospitals and Health Systems in Washington, DC. "That being said, we need to be cognizant of program integrity efforts that places undue burden on providers," she cautions.
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As a general rule, courts have upheld limitations on Medicaid reimbursements for services, as long as the services are "sufficient in amount, duration, and scope to reasonably achieve their purpose," according to Laura Hermer, JD, LLM, an assistant professor of health policy and bioethics at the University of Texas Medical Branch in Galveston.
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Would you expect a New York Medicaid client to be able to access mental health service equally well, regardless of where he or she lived within the state?
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While there is general agreement that temporary staff can threaten patient safety and increase malpractice risks, the question is not quite so clear with nurse practitioners (NPs) and physician assistants (PAs) in the emergency department (ED).
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E-mail practices and mobile e-mail cause the most concern for data protection and regulatory compliance, according to the 830 individuals whose responses were included in a study conducted by the Ponemon Institute and Zix Corp., an e-mail encryption service.
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The March of Dimes, based in White Plains, NY, recently began an initiative in New York, California, Florida, Texas, and Illinois to implement a "39-week toolkit" in hospitals to discourage C-sections or inductions before that minimum gestation.
