On Thursday, Sept. 3, the Centers for Medicare & Medicaid Services (CMS) launched Care Compare – an online consumer-facing database of provider quality information.
In January, CMS originally announced its plan to merge Home Health...CMS Rules
CMS makes move to drive value-based reimbursement for cancer and chronic kidney disease (CKD) and end stage renal disease (ESRD) with a new final rule. The End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model uses value-based care payments to encourage the usage of home dialysis and kidney transplants. The new model also benefits...CMS Rules
On Aug. 31 CMS issued a proposed rule that aims to make innovative devices and breakthrough technologies more accessible to Medicare beneficiaries.
Once the Medicare Coverage of Innovative Technology final rule goes into effect, national Medicare coverage will begin on the date of a breakthrough device’s FDA market authorization and...CMS Rules
On September 2, the Centers for Medicare & Medicaid Services (CMS) issued a final rule for acute care and long-term care hospitals that increases Medicare spending on acute care inpatient hospital services by about $3.5 billion and ties Medicare FFS inpatient hospital pay to MA negotiated rates in FY 2024.
Long-term care...CMS Rules
ACA-enrollment has dropped each year of the Trump presidency, a trend that’s also been seen in Arizona. The most recent data from Kaiser Family Foundation reports there are 153,020 Arizonans enrolled in marketplace plans. The Trump administration has dramatically cut funding for Navigators tasked with getting the word out about ACA...CMS Rules
The Centers for Medicare & Medicaid Services has strongly encouraged nursing homes to increase their efforts in controlling COVID-19 inside facilities after the number of residents infected reached a record high, and as new deaths have started rising once again.
Arizona is close to reopening nursing homes to visitors after...CMS Rules
Cigna is charged with falsifying the health conditions of its Medicare Advantage plan members, essentially scamming CMS out of larger payments to cover the cost of care for beneficiaries diagnosed through the insurer's medical assessment program.
Last year the Office of Inspector General undertook a study because it suspected...CMS Rules
Nursing homes, hospices, and inpatient psych facilities are getting some long overdue attention and can expect to see pay bumps come Oct. 1, albeit slightly less than previously proposed by CMS.
The final rule finalizes a 2.2% increase in overall payments to skilled nursing facilities in fiscal 2021. CMS says this means payments...CMS Rules
A U.S. Department of Health and Human Services watchdog reported that Seema Verma, Centers for Medicare and Medicaid Services chief, mishandled millions of dollars in federal contracts that ultimately benefited friends and former Trump officials.
The Office of Inspector General Report concluded Verma violated federal contracting...CMS Rules
Earlier this month, HHS repealed protections for transgender individuals seeking medical care and three days later, the United States Supreme Court delivered a ruling defending LGBT people from discrimination in the workplace under Title VII.
These two major changes in how the law impacts care for sexual and reproductive health...CMS Rules
Those who are older, lower income, minorities and have chronic conditions are at higher risk for COVID-19.
On June 22, CMS released sought-after Medicare data (Jan 1 to May 16) on beneficiaries’ COVID-19 outcomes that found that more than 325,000 beneficiaries were diagnosed with COVID-19 during that time.
Almost 110,000 were...CMS Rules
The announcement on Friday, June 19, CMS announced that MA plans must continue not to charge cost sharing (including deductibles, copayments, and coinsurance) or apply prior authorization or other utilization management requirements for COVID-19 tests and testing-related services.
The Centers for Medicare & Medicaid Services...CMS Rules
Centers for Medicare & Medicaid Services (CMS) recommends re-opening facilities to provide non-emergent, non-COVID-19 healthcare.
The Trump administration said Monday that healthcare facilities in states that have seen enough of a decline in COVID-19 cases to reach the Phase II criteria for reopening their economies should begin...CMS Rules
In response to the coronavirus, the Centers for Medicare and Medicaid Services (CMS) granted a special enrollment period (SEP) for Medicare beneficiaries through the end of June, giving Part D, Medicare Advantage and Medigap insurers an additional sales window. The SEP applies to those who were unable to enroll due to the pandemic....CMS Rules
Proposing a rule to amend risk adjustment methodology for exchange plans, the Centers for Medicare and Medicaid Services (CMS) aims to improve the accuracy and effectiveness of the Affordable Care Act (ACA)-era program. The agency seeks to refine the program's error rate calculation and risk adjustment data validation (HHS-RADV)...CMS Rules
Accountable care organizations (ACOs) are asking for more support from the Trump administration amid the pandemic. ACOs want more time to decide on whether to voluntarily exit the Medicare Shared Savings Program (MSSP) as coronavirus-related financial losses and balance sheet deficits pile up.
With payments tied to spending and...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) finalized requirements seeking to increase access to telehealth for seniors in Medicare Advantage (MA) plans. The changes made to MA and Medicare Part D also expand supplemental benefit options for beneficiaries with chronic diseases.
CMS will grant MA plans more flexibility to...CMS Rules
The Centers for Medicare & Medicaid Services (CMS) released the final payment notice for 2021 last week as the Trump administration finalized a string of regulatory changes to Affordable Care Act (ACA) marketplace. The agency's rule outlines ACA plan regulations that impact qualified health plans (QHP) for the 2021 coverage...CMS Rules
Along with an increase to Medicare inpatient payment rates, a Centers for Medicare and Medicaid Services (CMS) proposed rule released on Monday is suggesting price transparency requirements that include hospitals disclosing median payer-specific rates negotiated with Medicare Advantage organizations and third-party payers.
CMS is...CMS Rules
President Trump announced the formation of an independent commission last week to address the troubling number of coronavirus cases in nursing homes across the country. The Coronavirus Commission for Safety and Quality in Nursing Homes will conduct a comprehensive assessment of the nursing home response to the pandemic.
The...
