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...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...
