For the first time in the last decade, the Centers for Medicare and Medicaid Services (CMS) updated the popular health plan shopping tool Medicare Plan Finder, but the recent redesign initiative has raised concerns for consumer advocacy groups that say the tool offers inaccurate information.
The federal government spent $11 million...Arizona News
Hospital prices continue to be scrutinized as employer groups deem costs way too high and pressure from the Trump Administration to publish negotiated prices increases.
According to a Rand report, significant discrepancies were found between what private health plans pay for hospital services versus Medicare, highlighting that...National News
As the Centers for Medicare and Medicaid Services (CMS) considers possible changes to the methodology it uses to calculate hospital star ratings, some experts are worried the proposed adjustments do not adequately account for patient needs.
The agency announced in August plans to update the quality measurement methodology of the...CMS Rules
A new analysis of the decline in hospital readmission rates suggests ties to a drop in hospital admissions all together, rather than a Centers for Medicare and Medicaid Services (CMS) value-based purchasing program as previously credited.
The Medicare Hospital Readmissions Reduction Program (HRRP) is a value-based purchasing...CMS Rules
Medicare beneficiaries will see a 7 percent increase in monthly premiums and annual deductibles for 2020 Part B coverage, which takes care of physician services, outpatient hospital services, explicit home health services and durable medical equipment.
The Centers for Medicare and Medicaid Services (CMS) announces the rates for...CMS Rules
After the publication of the Outpatient Prospective Payment System (OPPS) on Friday, the Trump Administration is holding off on a controversial transparency rule that would require hospitals to publicly post all privately negotiated payer rates. The Centers for Medicare and Medicaid Services (CMS) has promised to issue a "forthcoming...National News
One of the country's oldest nonprofit health insurance plans allegedly exploited Medicare of millions; Seattle-based Group Health Cooperative was taken to federal court in a whistleblower case.
Filing suit against the health plan is one of the company's former medical billing managers, Teresa Ross, who alleges that Group Health...Arizona News
The Department of Health and Human Services (HHS) unveiled a proposal spearheaded by the Centers for Medicare and Medicaid Services (CMS) and the Office of the Inspector General (OIG) on Oct. 9 to make changes to anti-kickback legislation and Stark Law in an effort to modernize.
In a news release announcing the proposals, HHS...
In a letter dated Oct. 17, the Arizona Health Care Cost Containment System (AHCCCS) notified the Centers for Medicare & Medicaid Services (CMS) that it will postpone implementation of AHCCCS works until further notice, citing ongoing court battles over Medicaid work requirements and the "evolving national landscape concerning...
The Centers for Medicare and Medicaid Services (CMS) published a notice on Thursday informing hospitals of its plans to survey facilities to collect information on their acquisition costs for certain covered outpatient drugs included in the 340B Drug Discount Program.
The notice follows a July proposed rule from the Trump...Arizona News
Starting Oct. 1 therapy payments to nursing facilities will shift to a value-based model, emphasizing patient needs over the amount of services provided. The Patient Driven Payment Model (PDPM), a more individualized approach, aims to reduce inflated billing by basing payments on patient's medical characteristics.
The new approach...Arizona News
Arizona's Medicaid Program, the Arizona Health Care Cost Containment System (AHCCCS), is implementing work requirements beginning the fall of 2020 in Maricopa, Pima and Yuma counties. Eventually, nearly 120,000 Arizona residents on Medicaid will have to prove they are either working, studying or volunteering in order to continue...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) announced Aug. 15 that all plans on HealthCare.gov will be required to display quality star ratings during the 2020 open enrollment.
CMS said in a news release, the move builds on efforts by the Trump Administration to increase transparency and encourage informed coverage...Arizona News
In a speech given on Monday at the Better Medicare Alliance 2019 Medicare Advantage Summit, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma voiced concerns about the consequences a single-payer healthcare system including its impact on innovation with the elimination of private insurers.
Verma explicitly...Arizona News
A Government Accountability Office (GAO) report analyzed Centers for Medicare and Medicaid Services (CMS) data regarding abuse in nursing homes across the country and found abuse deficiencies in nursing homes had more than doubled in a four year period. Increasing from 430 claims in 2013 to 875 for 2017, or 103.4 percent with the...National News
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...