Medicaid Program Integrity Initiatives

On June 26, 2018, in Documents, Industry News, by AQ-IQ LLC

Today, the Centers for Medicare and Medicaid Services (CMS) announced new and enhanced initiatives designed to improve Medicaid program integrity through greater transparency and accountability, strengthened data, and innovative and robust analytic tools. Recent years have seen a rapid increase in Medicaid spending driven by several factors, including Medicaid expansion, from $456 billion in 2013 […]

Medicaid and CHIP Scorecard

On June 4, 2018, in Documents, by AQ-IQ LLC

Today, the Centers for Medicare & Medicaid Services (CMS) released the first ever Medicaid and Children’s Health Insurance Program (CHIP) Scorecard, a central component of the Administration’s commitment to modernize the Medicaid and CHIP program through greater transparency and accountability for the program’s outcomes. For the first time, CMS published state Medicaid and CHIP quality […]

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

On October 20, 2016, in Documents, by AQ-IQ LLC

Summary: In their continuing effort to improve the Medicare Program, CMS has created the Quality Payment Program (QPP), which provides two options (based on defined criteria): MIPS (Merit-based Incentive Payment System) and APMs (Advanced Alternative Payment Models). QPP ends the SGR (Sustainable Growth Rate) formula and uses reporting data to validate important metrics. More details […]

CMS Moratoria and Demonstration Project

On August 2, 2016, in Announcements, Industry News, by AQ-IQ LLC

CMS announced an extension and statewide expansion of fraud-fighting temporary provider enrollment moratoria efforts in six states, along with a new related demonstration project to allow for certain exceptions to the moratoria and heightened screening requirements for new providers.  CMS also announced it is immediately lifting the current temporary moratoria on all Medicare Part B, […]

Proposed Rule Amends State Flexibility for Medicaid Benefit Packages

On January 21, 2013, in Industry News, by AQ-IQ LLC

This proposed rule would lay out a structure and options for coordinating Medicaid, CHIP, and Exchange eligibility notices and appeals; provide additional benefits and cost-sharing flexibility for state Medicaid programs; and codify several provisions included in the Affordable Care Act and Children’s Health Insurance Program Reauthorization Act (CHIPRA). Key Provisions Process for Appeals of Eligibility […]

Aging and Disability Resource Center Program

On May 31, 2012, in Industry News, by AQ-IQ LLC

HHS announced a new $25 million funding opportunity to help states strengthen and expand their ability to help seniors and people with disabilities access home and community-based long-term services and supports.  Over the next one to three years, funding will support Aging and Disability Resource Centers (ADRCs) in nearly every state. Each year, more seniors, […]