Security Health Plan to manage musculoskeletal and prior authorizations

December 12, 2020
Effective Jan. 1, 2020, Security Health Plan will manage musculoskeletal procedure and outpatient therapy prior authorizations (PA) for members enrolled in certain Security Administrative Services (SAS) plans, regardless of the rendering provider. Click here to learn more, including the SAS plans and specific procedures and treatments that require PA from Security Health Plan. 

CMS Offers New Resources to Help Clinics Improve Physical Access for People with Disabilities

November 30, 2020

In recognition of the Americans with Disabilities Act, the Centers for Medicare and Medicaid Services Office of Minority Health (CMS OMH) offers several new resources to help improve physical accessibility for people with disabilities. The CMS memo describes resources available for providers as well as patients. Click here to view the memo and access links to important resources to help you make your practice more accessible.

Payment methodology changes for home health under new CMS PDGM model

December 1, 2019
Effective Jan. 1, 2020, the Centers for Medicare and Medicaid Services (CMS) will be implementing a new Home Health Patient-Driven Groupings Model (PDGM). The PDGM is a new payment model for the Home Health Prospective Payment System (HH PPS).

The PDGM relies more heavily on clinical characteristics and other patient information to place home health periods of care into meaningful payment categories and eliminates the use of therapy service thresholds. In conjunction with the implementation of the PDGM, there will be a change in the unit of home health payment from a 60-day episode to 30 days.

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