California Enacts Law Mandating Oversight of AI in Medical Necessity Decisions
California requires licensed healthcare professionals to oversee AI medical necessity decisions under a new law aimed at protecting patient care and fairness.
Healthcare Payers
Indiana Lawmakers Push Medicaid Reforms, Address Waitlists and Caregiver Services
Indiana lawmakers are tackling Medicaid reforms, addressing waitlists, caregiver services, and payment delays under the PathWays for Aging program.
Iowa HHS Designates Iowa Primary Care Association as Statewide Behavioral Health ASO
The Iowa Department of Health and Human Services has selected the Iowa Primary Care Association to oversee the statewide behavioral health system, enhancing coordination and service delivery.
Florida Expands Behavioral Health and Supportive Housing Assistance Pilot
Florida’s Agency for Health Care Administration proposes an expansion of its Behavioral Health and Supportive Housing Assistance Pilot, aiming to provide better access to services for residents with mental health and substance use disorders.
Florida Set to Spend $143 Billion on Medicaid Managed Care Contracts
Florida plans to allocate $143 billion to Medicaid managed care over six years, aiming to enhance healthcare for the poor, elderly, and disabled, under new contracts beginning in 2025.
Biden-Harris Administration Launches VBP Initiative to Boost Kidney Transplant Access
CMS has introduced a new rule to improve access to kidney transplants and enhance care quality, part of a six-year mandatory initiative by CMS aiming to increase efficiency and access nationwide.
Uncertainty in Home Health Care with CMS ‘Overpayment’ Clawbacks Looming
Home health providers face uncertainty as CMS clawbacks loom, with billions in potential repayments impacting the industry’s financial stability.
CMS Expands AHEAD Model to Include New York and Rhode Island
CMS announces the addition of Rhode Island and parts of New York to the AHEAD Model, expanding efforts to improve healthcare outcomes and manage spending across six states.
Medicare Shared Savings Program Reports $2.1 Billion in Savings for 2023
The Centers for Medicare & Medicaid Services (CMS) has announced a 0.5% increase in home health payments for 2025 alongside deeper permanent cuts, sparking debate among healthcare providers.
Medicare Shared Savings Program Reports $2.1 Billion in Savings for 2023
The Medicare Shared Savings Program achieved its highest-ever savings in 2023, with more than $2.1 billion saved and significant improvements in healthcare quality.