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Plans See Practical Challenges In Finalized MCO Rule, Beneficiary Advocates Celebrate Win

Medicaid beneficiary advocates and health plans are on opposite sides when it comes to the new requirements for managed care plans CMS finalized earlier this week -- while advocates call the rule’s timeliness and provider directory standards a win for beneficiaries, plans say the agency will have to work with them to address practical issues with implementation and have voiced concerns over using secret shoppers to check compliance.

Bird Flu News

FDA, Industry Weigh Potential Pathway For Bird Flu Antigen Vaccine As Precaution

While still downplaying the potential risk to humans as testing continues after avian influenza was detected in 20% of milk sampled, administration officials Thursday (April 25) said FDA is working with industry on an appropriate regulatory pathway for rolling out vaccines made with that bulk antigen if necessary, and a vaccination prioritization plan based on responses to previous disease outbreaks is available if needed.

Latest News

CBO Could Expand Budget Window For Hepatitis C Bill

The Congressional Budget Office (CBO) is looking at expanding its evaluation of the value of diagnosis and treatment of hepatitis C beyond a 10-year budget window, as it scores a bill expanding coverage for hep C treatment.

Patent And Trademark Office Sets Webinar On AI Guidance

The U.S. Patent and Trademark Office will host a May 15 webinar to discuss its guidance on using artificial intelligence tools “in practice” before the USPTO.

CMS Still Working On Rulemaking For Advanced EOB Requirement

External stakeholders are still working to develop standards for the electronic transfer of data that providers and payers will need to comply with the No Surprises Act requirements that consumers have information about costs before receiving health care services, and CMS is exploring ways to pilot test those standards, according to a new progress report on the implementation of the NSA’s Good Faith Estimate (GFE) and (AEOB) requirements.