Summary of Final Rule: “Medicare Program: Changes to the Medicare Claims and...
Summary of OMHA final Rule
View ArticleSimon&Co. Organizes Stakeholder Letter Urging Congress To Reject Bill That...
Letter here Story in InsideHealthPolicy here (subscription required)
View ArticleEllen Murray Joins Simon&Co.
Ellen Murray, J.D., is joining Simon&Co., a health policy consulting firm, as Of Counsel. Ms. Murray served as the Chief Financial Officer (CFO) and Assistant Secretary for Financial Resources at...
View ArticleProposals to Address Fraud, Waste and Abuse in Medicaid NEMT
NEMT Program Integrity Options
View ArticleAssessing the Medically Frail Among Medicaid Expansion Beneficiaries:...
Assessing the Medically Frail
View ArticleState SPAs Reimburse 340B Covered Entities at Actual Acquisition Cost (AAC):...
Since the 2016 Covered Outpatient Drugs final rule, states submitting SPAs have defaulted to AAC to reimburse 340B eligible entities. This removes incentives for 340B clinics to choose drugs that cost...
View ArticleNew White Paper Posted
State SPA Reimbursement to #340B Covered Entities Creates Disincentives to Choose the Lowest Cost Drugs https://t.co/51c8aReX3f … — Simon&Co. (@MJSimonandCo) August 22, 2017
View ArticleSimon&Co. Organizes Letter Opposing MA Proposal to Waive NEMT for 300,000...
MA Sign On Letter Opposing Waiving NEMT
View ArticleAdvocates protest Gov. Charlie Baker’s proposed cut to MassHealth...
Read full story here
View ArticlePresident Marsha Simon’s Article in Health Affairs
Non-Emergency Medical Transportation has been a #Medicaid benefit since the beginning -will reform sacrifice it? https://t.co/D9kfLJsP00 pic.twitter.com/p0PWtU4KES — Health Affairs (@Health_Affairs)...
View ArticleBishop Leads Letter In Support Of Medicaid Transportation Services
Rep. Sanford Bishop leads letter to stop bill that allows states to terminate transportation for dialysis patients #NEMT #Medicaidhttps://t.co/KsvciWz0c1 — Simon&Co. (@MJSimonandCo) November 6, 2017
View ArticleCMS: Stop Approving Medicaid Waivers to Drop Non‑Emergency Transportation,...
Click here to read paper
View ArticleCMS Rule Fails to Implement Auto-Escalation of Appeals
In their proposed rule (CMS-4182-P) with changes to Medicare Parts C and D, CMS failed to implement auto-escalation of appeals to an independent review entity, a statutory requirement. See more in...
View ArticleCMS’ Approval of Kentucky’s Plan to Deny Transportation to Methadone...
In the guidance to state Medicaid programs to better address the opioid epidemic, CMS strongly encourages states to demonstrate the value of evidence-based treatment to meet the needs of people...
View ArticleSenate HELP Hearing Probes Original Purpose of 340B Drug Discount Program
Read President Marsha Simon’s blog on the intent of the program
View ArticleSenate HELP Hearing Probes Original Purpose of 340B Drug Discount Program
Congress created the 340B program in 1992 with bipartisan support to allow health providers that serve large numbers of low-income patients to receive discounted medication from drug companies. In...
View Article