The Centers for Medicare & Medicaid Services (CMS) released a proposed rule last Wednesday that delays the implementation of a Trump-era rule which would incentivize the use of value-based drug pricing agreements for the Medicaid program. The...CMS Rules
On June 7 at 5 p.m., AHCCCS is hosting an online community forum to solicit feedback from stakeholders about the American Rescue Plan Act home and community based services expenditure enhancement.
AHCCCS will use the feedback to submit a spending plan to the Centers for Medicare and Medicaid Services by June 12 this year.
Last week, President Joe Biden announced that he would roll back a controversial Trump-era rule that would have required green card applicants and other immigrants to demonstrate that they would have health insurance upon arrival to the U.S. The so-called "public charge" rule would have allowed the government to deny visa applications if...CMS Rules
Medicare's older adults still like their coverage and report fewer cost-related problems than privately insured adults ages 50 to 64, despite receiving similar care to that age bracket.
The study from Kaiser Family Foundation said that rapidly growing healthcare spending is of concern for consumers and the relatively high prices from...
Health is both mental and physical health, and until we recognize this as a community, we will struggle to address the health of our community, according to TMC Healthcare.
The U.S. Department of Health and Human Services estimates that one in five Americans over age 18 will experience a mental health problem in a regular year. The...
The Centers for Medicare and Medicaid Services (CMS) is deep into Medicare alternative payment model (APM) revision and adjustment. One such program undergoing review is the Medicare Shared Savings Program (MSSP) and the revisions include major changes to quality reporting methodologies, the crux of the program.
CMS posted its final...CMS Rules
On Sunday, the Centers for Medicare & Medicaid Services (CMS) issued two proposed rules for inpatient and long-term care hospitals. The first aims to fund medical residency positions in hospitals in rural and underserved communities in order to address workforce shortages in those areas and would require hospitals to report COVID-19...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) issued a final rule making changes to the Comprehensive Care for Joint Replacement (CJR) payment model last week. The final rule extends the payment model for three performance years for participating hospitals and allows for CMS to test modifications to the model.
The final rule...CMS Rules
After a 1.7 billion in nursing home payment increase, the federal government is mulling several options to recalibrate the Medicare payment structure for skilled nursing facilities as it seeks to achieve its intended goal of budget neutrality, with the aim of shutting off excess payments as soon as possible.
According to the...CMS Rules
The Medicare Payment Advisory Commission (MedPAC) agreed that the Department of Health and Human Services (HHS) must put together a consolidated group of alternative payment models in order to improve demonstrations.
From the commission's recommendation:
The Secretary should implement a more harmonized portfolio of fewer spending...CMS Rules
This week, the Supreme Court suspended hearings on Medicaid work requirements as other Trump era Medicaid policies come under fire. Plus, states aren't quite meeting reporting requirements and more reporting adjustments could be on the way.
The U.S. Supreme Court suspended its review of the Medicaid work requirements and removed the...CMS Rules
Provider groups aren't too worried about the 2% Medicare payment cut that is scheduled to go back into effect on April 1st after being paused for the COVID-19 pandemic. The cuts originally went into effect in 2013 and were paused to protect providers like hospitals and doctor groups that are now confident that the cuts will continue to...CMS Rules
The American Journal of Managed Care published a study last Friday looking at the increase of outpatient knee replacement surgeries paid through private insurance after the Centers for Medicare and Medicaid Services' (CMS) decision to remove knee replacements from the Inpatient Only list.
According to the AJMC study, there was an...CMS Rules
The newly installed Biden Administration and the ongoing turbulence of the pandemic have resulted in a flurry of recent changes in the world of the Affordable Care Act—all as an impending Supreme Court decision on its very existence looms in the background.
Many Americans lost jobs due to the pandemic, and with them their...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) price transparency rule went into effect on January 1st. The rule, which requires that hospitals disclose prices of basic procedures in searchable files or consumer-friendly interfaces, was met with uncertainty and criticism from hospitals and other stakeholders for being too strict a...CMS Rules
On January 14, the Centers for Medicare and Medicaid Services (CMS) released the Notice of Benefit and Payment Parameters for 2022. This included a finalized user fee of 2.25% of premiums for insurers on the federally facilitated exchange. The rule also allows states to enroll eligible patients in the individual marketplace.
Last Friday, the Centers for Medicare and Medicaid Services (CMS) approved a final rule requiring payers to build application program interfaces to support data exchange and streamline prior authorization. Medicaid and the Children’s Health Insurance Program (CHIP); healthcare exchange plans are also required to comply with the...CMS Rules
Last Thursday, the Centers for Medicare & Medicaid Services proposed that states could use Section 1332 waivers to customize their Exchanges and allow web-based insurers to sell insurance by 2023; some stakeholders contend the changes undermine key tenets of the Affordable Care Act.
The agency's final rule, Notice of Benefit and...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) released 20 new proposed measures for quality and efficiency measures under consideration. CMS reviews and updates all quality measures annually for its programs, reviewing and removing less relevant ones and proposing more innovative metrics.
From CMS Administrator Seema...CMS Rules
On Tuesday, the United States Court of Appeals for the District of Columbia ruled that the Department of Health and Human Services may continue with the hospital price transparency rule on January 1. The American Hospital Association requested an injunction against the 2019 final rule that will require hospitals to make their standard...