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CMS Posts Tentative List of Essential Community Providers

The Centers for Medicare & Medicaid Services has posted on its web site a draft list of essential community providers for 2018.
iStock_000001497717XSmallTo qualify as essential community providers, organizations must serve predominantly low-income, medically underserved patients.  Qualified health plans must contract with at least 30 percent of the essential community providers in their markets and must offer contracts in good faith to at least one such provider in each of six categories, including federally qualified health centers, hospitals, and family planning providers.
Providers that believe they have mistakenly been excluded from the list may petition for inclusion.
Find the draft list here.

2016-09-08T06:00:07+00:00September 8th, 2016|Uncategorized|Comments Off on CMS Posts Tentative List of Essential Community Providers

PA Health Law Project Issues Newsletter

The Pennsylvania Health Law Project has released its latest newsletter.
Among the issues addressed in the letter are the prospects for Medicaid expansion in Pennsylvania and increased state oversight of the state’s private Medicaid managed care organizations.  The newsletter also describes an effort by the U.S. Department of Health and Human Services to encourage all qualified health plans offered through health insurance exchanges to include “essential community providers” in their provider networks.
Find the newsletter here, on the web site of the Pennsylvania Health Law Project.

2013-06-20T06:00:15+00:00June 20th, 2013|Pennsylvania Medicaid policy|Comments Off on PA Health Law Project Issues Newsletter
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