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OIG Issues Favorable Advisory Opinion on Telehealth Marketplace MSO-PC Arrangement

The Department of Health and Human Services, Office of Inspector General (OIG) recently issued a favorable advisory opinion under the federal Anti-Kickback Statute (AKS), wading into the world of not only telehealth but also...more

GAO Report Gives MA Organizations and Behavioral Health Providers Food for Thought on Prior Authorization

The US Government Accountability Office (GAO) recently released a report on the Centers for Medicare and Medicaid Services (CMS)’s oversight of prior authorization criteria for behavioral health services (BHS) by Medicare...more

CMS Releases New Proposed Rule for Medicare Advantage and Part D

On December 10, 2024, the Centers for Medicare and Medicaid Services (CMS) released a Proposed Rule for revisions to the regulations governing the Medicare Advantage (MA) program, Medicare Prescription Benefit (Part D),...more

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