Alignment Health’s Post

Kind of wonderful that while attending the ADvancing States #HCBS conference, Centers for Medicare & Medicaid Services releases guidance to states to promote continued coverage for #HCBS: "Access to HCBS can mean the difference between an individual’s ability to continue receiving services and supports in their home or community setting and institutionalization. CMS strongly encourages states to adopt flexibilities and strategies that facilitate ongoing coverage for individuals receiving HCBS." https://lnkd.in/g7wWZK3J

Medicaid has been a hot topic in the news lately, especially with the 2024 election coming up. 1.7 million in Texas and another 342K from Ohio are losing their coverage while North Carolina, Illinois, and Kansas are expanding their coverage. A DC therapist stole $263K from the Medicaid system and Vermont is seeing and uptick in Medicaid fraud cases. These are all headlines from just the past week. Politicians often like to include Medicaid and Medicare in their election promises, but rarely have they followed through on it. Not only are we struggling at a state level to standardize Medicaid, but our Medicare system that takes care of the elderly and disabled is in serious trouble. While the system is losing money every year, the federal government is finding it difficult to administer the system. You should watch this report from NBC news on how Medicare Advantage is now routinely denying reimbursements. If hospitals and clinics will be rejected when payments are submitted, more and more locations will stop accepting it. This will factoring into the 2024 election in a huge way. https://lnkd.in/e2Qs-74e

Medicare Advantage sales never stop! AEP season might be done but between SEP's, OEP, and DSNP's, there are more than enough opportunities to stay engaged and increase sales. DSNP is the fastest growing segment of Medicare Advantage. 125% growth in 5 years. SNPs are now 20% of total MA members. 90% of SNPs are dual eligible - eligible for both Medicare and Medicaid. Can be sold all year, not just AEP or aging in. More than enough data to prove a point here -> https://lnkd.in/gDaBwScg #amerilifemarketinggroup #yourfmo #medicareadvantage

There are lots of questions about broker compensation reform. Like “How does Centers for Medicare & Medicaid Services define broker compensation?” Or “How will they enforce it?” Get the answers to these questions and more in our “Broker Compensation Reform CY 2025 MA and Part D Policy and Technical Changes” FAQ here: https://lnkd.in/eM3D-bYH

On May 22, 2024, the Centers for Medicare and Medicaid Services (“CMS”) announced that it would be implementing updated 2024 spousal impoverishment standards that will take effect on July 1, 2024. Read more here >>> https://ow.ly/jSQh50SjTGS #medicaidlawfirm #stotlerhayesgroup

The Centers for Medicare & Medicaid Services (CMS) finalized the Medicaid Disproportionate Share Hospital (DSH) Third-Party Payer Rule on February 23, 2024. This rule, influenced by the Consolidated Appropriations Act (CAA) of 2021, alters how Medicaid hospital-specific #DSH limits are calculated, particularly concerning third-party payments under section 203 of the CAA. The rule also addresses administrative inefficiencies and offers clarifications on the DSH program. To learn more about the key provisions of the #finalrule, visit our website: https://okt.to/dmXxBE

Great information about LTC Partnership Agreements, Medicaid and Asset-Disregard! A Partnership-Qualified policy allows assets to be protected "dollar for dollar" with a properly design partnership-qualified LTC policy.

WHICH STATES HAVE LTC PARTNERSHIP AGREEMENTS WITH MEDICARE? Most states have Partnership Programs with Medicaid. These state laws allow non-exempt assets (for Medicaid qualification) to be protected “dollar for dollar” through benefits paid under an LTCI policy. bit.ly/AP-LTCIP #AgingPlan #MyAgingPlan #WolfLTC #longtermcare #planforcare #fiduciary #planning #retirementplanning

WHICH STATES HAVE LTC PARTNERSHIP AGREEMENTS WITH MEDICARE? Most states have Partnership Programs with Medicaid. These state laws allow non-exempt assets (for Medicaid qualification) to be protected “dollar for dollar” through benefits paid under an LTCI policy. bit.ly/AP-LTCIP #AgingPlan #MyAgingPlan #longtermcare #longtermcareinsurance #LTCI 

The first step in a Center for Medicare & Medicaid (CMS) submission process is the completion of an #MSA. Our Medicare Lien/Conditional Payment services help clients navigate the Medicare system to secure the approval of settlements by the CMS: http://ow.ly/N6Uq50AKDh4 #ExamWorks #MSPCompliance #IME #MedicareCompliance #ConditionalPayments