CMS-2390-P Requires Comments from Parents, Professionals and Advocates

In response to my June appeal for comments to CMS-2390-P, especially the section that explains how the parents of disabled children can be held financially responsible for the repayment of the cost of treatment delivered to their disabled child if they lose the final appeal of a Managed Care Organization’s denial of funding) I received the following e-mail message from an advocate. Steve,  The federal … Continue reading CMS-2390-P Requires Comments from Parents, Professionals and Advocates

URGENT! Comments Needed on Proposed Medicaid Policy Changes That Will Hurt Millions of People

The rate of comment submissions regarding proposed Medicaid changes (2390-P) has increased seventy-five percent but there are still just 23 comments posted. By this point in the comment period for a previous CMS proposed rule change, there had been over 500.  This new set of rule changes is flying way, WAY below the radar, unfortunately, and millions of people are going to suffer because of it. … Continue reading URGENT! Comments Needed on Proposed Medicaid Policy Changes That Will Hurt Millions of People

CMS Affirms That Parents Can be Held Financially Liable During Appeals of MCO Funding Denials

The Centers for Medicare and Medicaid Services issued a Proposed Rule (#2390) a few days ago.  The comment period ends on July 27th.  You can read the 8 comments I’ve sent them so far by clicking here. When you read my comments, you will see that there are some very good things planned in Washington for the States to comply with, and some absolutely dreadful … Continue reading CMS Affirms That Parents Can be Held Financially Liable During Appeals of MCO Funding Denials

Will a Medicaid MCO Violate Federal Laws and State Regulations to Gag Providers?

Here are the rules.  The question now is, will the Pennsylvania Medicaid Managed Care Organization that proposes to prevent its treatment providers from being advocates for their clients actually put their proposal into effect?  They claim that advocacy “is not the provider’s responsibility” but that flies in the face of the law.  Will they violate two Federal laws and State Regulations to gag providers who … Continue reading Will a Medicaid MCO Violate Federal Laws and State Regulations to Gag Providers?

CMS: Mental Health Parity Proposed Rule for Medicaid and CHIP

I just discovered this very important information about funding for mental health treatment for children, and adults, enrolled in medicaid and there are only three days left to comment on it.  CMS proposes mental health parity rule for Medicaid and CHIP Proposed rule will strengthen access to mental health and substance use disorder benefits for low-income Americans The Centers for Medicare & Medicaid Services (CMS) … Continue reading CMS: Mental Health Parity Proposed Rule for Medicaid and CHIP

CMS Proposes New Rule to Curb Denial Powers of Managed Care

The Centers for Medicare and Medicaid Services (CMS) has issued a Proposed Rule (CMS-2390-P) that states on pages 148 to 149 of the Public Inspection version of the document: “While we recognize that MCOs, PIHPs, and PAHPs have flexibility in applying utilization management controls for covered services, exercising that flexibility could result in the inappropriate curtailment of necessary services, particularly for those requiring on-going and … Continue reading CMS Proposes New Rule to Curb Denial Powers of Managed Care