Retium Health https://retiumhealth.com/ Provider Network Adequacy Fri, 25 Mar 2022 21:47:52 +0000 en-US hourly 1 https://wordpress.org/?v=7.0 https://retiumhealth.com/wp-content/uploads/2022/01/favicon-150x150.png Retium Health https://retiumhealth.com/ 32 32 HSD Reference File https://retiumhealth.com/hsd-reference-file-2/ Fri, 25 Mar 2022 21:47:52 +0000 https://retiumhealth.com/hsd-reference-file-2/ Each year CMS updates their HSD table to account for changes in county designations (changes in population) and feasibility to meet time and distance criteria based on availability of providers. On CMS page see Downloads and click on HSD_2022_Reference File_updated_01_07_2022

La entrada HSD Reference File se publicó primero en Retium Health.

]]> Each year CMS updates their HSD table to account for changes in county designations (changes in population) and feasibility to meet time and distance criteria based on availability of providers.

Link to HSD Table

On CMS page see Downloads and click on HSD_2022_Reference File_updated_01_07_2022

La entrada HSD Reference File se publicó primero en Retium Health.

]]> Medicare Advantage and Section 1876 Cost Plan Network Adequacy Guidance https://retiumhealth.com/medicare-advantage-and-section-1876-cost-plan-network-adequacy-guidance/ Tue, 25 Jan 2022 16:16:33 +0000 https://retiumhealth.com/2022/01/25/cy-2021-medicare-advantage-and-prescription-drug-program-proposed-rule-2/ CMS issued an update to their network adequacy guidance on March 4, 2022. This document is developed by CMS and offers details regarding MA network adequacy requirements, specialty types, quantitative measurements of network adequacy, compliance and enforcement efforts, instructions to upload HSD table, and exception requests instructions.

La entrada Medicare Advantage and Section 1876 Cost Plan Network Adequacy Guidance se publicó primero en Retium Health.

]]> CMS issued an update to their network adequacy guidance on March 4, 2022. This document is developed by CMS and offers details regarding MA network adequacy requirements, specialty types, quantitative measurements of network adequacy, compliance and enforcement efforts, instructions to upload HSD table, and exception requests instructions.

Link to document

La entrada Medicare Advantage and Section 1876 Cost Plan Network Adequacy Guidance se publicó primero en Retium Health.

]]> CY 2023 Medicare Advantage and Prescription Drug Program Proposed Rule https://retiumhealth.com/cy-2021-medicare-advantage-and-prescription-drug-program-proposed-rule/ Tue, 25 Jan 2022 16:16:33 +0000 https://retiumhealth.com/?p=1 CMS issued its proposed rule for Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs. CMS is “proposing to require an applicant to demonstrate compliance with network adequacy standards as part of the MA application process for new and expanding service areas and to adopt a time-limited […]

La entrada CY 2023 Medicare Advantage and Prescription Drug Program Proposed Rule se publicó primero en Retium Health.

]]> CMS issued its proposed rule for Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs.

CMS is “proposing to require an applicant to demonstrate compliance with network adequacy standards as part of the MA application process for new and expanding service areas and to adopt a time-limited 10 percentage point credit toward meeting the applicable network adequacy standards for the application evaluation”. This will start with CY 2024.

Link to document

La entrada CY 2023 Medicare Advantage and Prescription Drug Program Proposed Rule se publicó primero en Retium Health.

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