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Obtaining payment for the important services provided to Indiana’s elderly and disabled is critical to the success of communities and the hands-on care provided each and every day. IHCA/INCAL has led the way in the development of Medicaid policy and advocacy, while AHCA/NCAL concentrates on policy and advocacy in the Medicare program, to help skilled nursing facilities and assisted living communities to receive compensation for their services.
The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that would streamline processes related to prior authorizations (PA) for medical items and services. The proposed rule would also make information on plan PA performance – such as timeliness, as well as plan reasons for and methods of denials – public to providers and beneficiaries.
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Indiana’s Case Mix reimbursement system is complex and frequently changing. We track and provide guidance on a range of matters from Quality Assessment Fee to Payment Add-ons to Value based Purchasing to Cost Reports and Audits.
We also engage in policy development and expansion of Medicaid Long Term Services and Supports, Medicaid Waiver and Home and Community Based Services.
The intersection of quality and payment in the Medicare program continues to advance at a rapid pace. We help members learn and adapt to these changes. Data and guidance on the Patient Driven Payment Model, SNF VBP, Quality Reporting Program, are available for members to access.
Revenue Cycle Director , CarDon and Associates, Inc.
Elizabeth Eichhorn, eeichhorn@ihca.org