A proposed rule from the Centers for Medicare and Medicaid Services (CMS) last week would increase home health payments and eliminate a quality measure from the reporting program.
Net payments would increase by $250 million in 2020, or 1.3 percent, to ensure that home health payments remain consistent with current year statutory...Arizona News
Provider directories for Medicare Advantage (MA), the private alternative to traditional fee-for-service Medicare, have historically shown to be highly unreliable and audits performed by the Centers for Medicare and Medicaid Services (CMS) reinforced that notion by reporting inaccuracies in nearly half of all MA online provider...Arizona News
Scrutiny on healthcare policy is intensifying following recent warnings from House Democrats against Affordable Care Act (ACA) changes, citing an internal memo sent by Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma to Health & Human Services Secretary Alex Azar in August.
The memo from Verma...Arizona News
Work requirements for Medicaid beneficiaries have currently been approved in nine states, including Arizona, and an estimated 76,000 to 103,000 Arizonans could lose coverage as a result. Hundreds of thousands of other beneficiaries across eight other states are also at risk of losing their coverage after 12 months of implementation,...Arizona News
The Centers for Medicare and Medicaid Services (CMS) issued a termination notice last week disclosing that Hacienda Healthcare will no longer participate in the Medicaid program as of July 3.
The termination follows a Notice of Intent from The Arizona Department of Health Services (AZDHS) to revoke the skilled nursing facilities license...Arizona News
The Centers for Medicare and Medicaid Services has finalized a rule intended to make prices more transparent with Medicare Part D drug plans and allow plan sponsors to use cost-cutting tools such as step therapy under certain circumstances.
"CMS is delivering on price transparency, because patients have a right to know the cost of...National News
The Centers for Medicare and Medicaid Services (CMS) acknowledged the importance of social determinants of health in a Wednesday blog post encouraging healthcare providers to utilize new resources and data-driven approaches to addressing non-clinical factors.
The blog post, by Cara James, director of the CMS office of Minority...Arizona News
Safety net hospitals are set to be the winners from the new Medicaid reimbursement rules under the Hospitals Readmissions Reduction Program that categorizes hospitals into five groups based on the percentage of a hospital’s patient population participating in dual enrollment of Medicare and Medicaid.
A new study, published in...National News
Skilled nursing facilities (SNFs) get some insight into the selection process used by Medicare accountable care organizations (ACOs). Some of the coordination strategies include home visit programs and the exchange of data between primary care and emergency departments.
The strategies are outlined in a new Centers for Medicare and...Arizona News
Earlier in the year payers and providers worried that putting an end to the practice of silver-loading would destabilize Affordable Care Act (ACA) exchanges. The Trump administration announced last week that it would continue to allow the practice on the individual market for the next year.
Silver-loading enabled insurers to...Arizona News
The Trump administration took a blow last week in healthcare policy as a federal judge blocked Medicaid work requirements in both Kentucky and Arkansas. Currently, eight states have received approval form the Centers for Medicare and Medicaid Services (CMS) for waivers to establish work requirements, the most recent being Arizona, which...Arizona News
The healthcare industry has been swept by innovation in recent years as telemedicine has gained steam in offering solutions for lack of transportation and access to specialists. Artificial Intelligence (AI) has long been discussed as a possible solution for issues in the diagnostic and medical devices space, but as spending on AI tools...National News
Updated guidance was sent to the nation's Medicaid directors from the Centers for Medicare and Medicaid Services (CMS) that provided clarification regarding where Medicaid beneficiaries are eligible to use home and community-based services (HCBS). The guidance aims to streamline and shed light on the agency's 2014 final rule's...Arizona News
In a continued fight against soaring drug prices, the Trump administration is moving forward with a proposal introduced in Oct. 2018 that would require drug manufactures to feature the list prices of its products during television commercials.
According to The New York Times, the White House is currently in the process of...Arizona News
Two studies highlight the role of health plans in driving up out-of-pocket prescription drug costs for 2019 individual Affordable Care Act (ACA) exchange enrollees, while insurers continue to file lawsuits against the federal government for unpaid cost-sharing reduction payments (CSRs).
Multiple insurers filed status reports in...Arizona News
Prescription drug spending and pricing data for 2017 was added to the Centers for Medicare and Medicaid Services' (CMS), updated drug dashboards to indicate spending per dosage of prescription drugs under Medicaid and Medicare Parts B and D. The data is tracked by changes in the average spending per dose.
In its first update since...Arizona News
The Centers for Medicare and Medicaid Services (CMS) announced the release of updated hospital performance data on the Hospital Compare website and data.medicare.gov. The agency also announced on Feb. 28 that it would post potential changes to the star rating methodology for public comment and feedback in attempts to improve the way...Arizona News
Various insurers, hospitals, and state regulators are encouraging the Centers for Medicare and Medicaid Services to continue a practice dubbed "silver loading" in fear that ending the rule would destabilize Affordable Care Act (ACA) exchanges.
Health insurers typically raise premiums on silver-level exchange plans to recover the...Arizona News
A new study from Milliman suggests that 577 Medicare Advantage plans are offering at least one or more supplementary benefits offered by long-term care insurance policies. CMS is encouraging Medicare Advantage plans to provide coverage with added benefits that can be seen as an alternative to traditional fee-for-service Medicare...Arizona News
Under the Affordable Care Act (ACA), statistics on healthcare coverage noted a closure of the gap in the number of people of various races and ethnicity who have health insurance, but a Kaiser Family Foundation brief has highlighted trends indicating that between 2016 and 2017, some groups of color have experienced a stagnation in health...