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CMS Responds to Network Adequacy Concerns
Federal regulators are trying to set expectations and a tentative schedule for public exchange plans in 2015; they're also proposing a new approach to network adequacy and essential community providers, after complaints from consumers and providers in a few markets.
Federal regulators are trying to set expectations and a tentative schedule for public exchange plans in 2015; they're also proposing a new approach to network adequacy and essential community providers, after complaints from consumers and providers in a few markets.
The last date to submit health plans for certification through either the state or federal rate review system will be Sept. 4, which will allow time for multiple rounds of applications and resubmission before certification is finalized Oct. 17, the Center for Consumer Information and Insurance Oversight wrote in a summary of various proposed and final rules.
Regardless of what state they’re selling in, insurers may have some new information to submit to the Centers for Medicare & Medicaid Services this summer. Regulators said they’re going to be asking for lists of all in-network and out-of-network hospitals, primary care, mental health and oncology providers, and determine whether they offer patients “reasonable access” in their service area.
Read the full story here: http://bit.ly/1bNfqva
Source: Healthcare Payer News
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
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Insufficient Data, Disparities Plague Lung Cancer Risk Factor Documentation
September 24th 2023On this episode of Managed Care Cast, we speak with the senior author of a study published in the September 2023 issue of The American Journal of Managed Care® on the importance of adequate and effective lung cancer risk factor documentation to determine a patient's eligibility for screening.
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Contributor: More Informed Management of Preeclampsia Is Necessary
November 29th 2023At present, it is difficult for clinicians to identify patients at greatest risk for developing preeclampsia with severe features and tailor treatment plans for them; this difficulty increases costs significantly.
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Study Validates Smartphone Analysis for Predicting Obstructive Sleep Apnea
November 29th 2023Findings show breathing sounds recorded by smartphones during sleep at home can reliably identify obstructive sleep apnea, presenting an innovative and accessible alternative to traditional in-laboratory polysomnography.
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