On Monday, the Centers for Medicare and Medicaid Services (CMS) along with the Department of the Treasury released revised guidance giving states more regulatory power with innovation waivers under the Affordable Care Act (ACA).
The way CMS evaluates and accepts waivers regarding innovation for each state's individual market is...Arizona News
The personal information of approximately 75,000 people was breached last month after a government run healthcare sign-up system was hacked. The Centers for Medicare and Medicaid Services (CMS) announced the news on Friday, Oct. 19 just a few weeks before the Affordable Care Act exchange opens up for open enrollment.
CMS administrator...Arizona News
An Alternative Payment Model (APM) is one way of delivering value-based care, as the shift from traditional fee-for-service to a value-based payment model continues, programs are continuously looking to serve as a catalyst in offering cost-effective, higher-quality care. APMs incentivize this goal and can apply to an episode, condition,...Arizona News
Medicare Advantage has been dominating healthcare headlines, especially with the start of the annual enrollment period; it is no secret the Medicare alternative pulls monstrous profits, but their means are in question. A study conducted by the Health and Human Services' (HHS) Office of the Inspector General (OIG) found that MA...
On Monday, the Centers of Medicare and Medicaid Services (CMS) proposed a rule that would require drug companies to list drug costs in their direct-to-consumer advertisements. In an initiative to inform beneficiaries of drug costs, the agency anticipates it will help minimize their out-of-pocket costs along with Medicare and Medicaid...
The Centers for Medicare and Medicaid Services (CMS) announced on Tuesday, almost 1,300 providers have signed themselves up to test-drive the Bundled Payment for Care Improvements (BPCI) advanced model.
Among the Arizona participants are:
Desert Institute Spine Care
Desert Orthopedic Specialists
Flagstaff Medical...Arizona News
Tennessee is now the fourth state to introduce a work requirement proposal for Medicaid enrollees, joined by Alabama, Michigan, and Virginia who also posted their proposals this month.
The waiver would require enrollees to seek or maintain work in order to keep Medicaid benefits. The state's requirements will specifically focus on...National News
On Monday the Centers for Medicare and Medicaid Services (CMS) issued a proposal to relieve healthcare providers of Medicare's unnecessary compliance burdens.
According to the CMS press release, the updates would save healthcare providers approximately $1.12 billion annually.
CMS Administrator Seema Verma attributed this...National News
UnitedHealthcare won its case over a 2014 rule implemented by the Centers for Medicare and Medicaid Services (CMS) requiring that Medicare Advantage organizations report and return any identified overpayments. The rule was deemed arbitrary and capricious.
U.S. District Court Judge Rosemary Collyer vacated the rule in its entirety,...Arizona News
As an alternative Medicare payment model, bundled payment for care improvement (BPCI) programs aim to reduce spending by creating incentives for providers to remove expendable costs.
Bundled payments are “episode-based,” relevant to specific conditions or treatments in which providers are expected to absorb service costs and...News
In 2011 Medicare agreed to pay for a minimally invasive surgical procedure--transcatheter aortic valve replacement (TAVR)--that replaces leaky heart valves through the blood vessels, aiming to offer relief for patients who were in too much of a fragile state for more invasive procedures like open heart surgery.
The catch is that...Arizona News
The Centers for Medicare and Medicaid Services (CMS) on Thursday, Aug. 16 announced key changes to the Medicaid Review Process that are designed to significantly reduce approval times for state Medicaid agencies.
Sometimes a simple request can mean enduring several months of review. CMS said its now...National News
Four major U.S. cities are suing President Trump and his administration for deliberately attempting to ensure the Affordable Care Act (ACA) fails, thus violating the president's constitutional duty to execute laws faithfully under the Take Care Clause.
Representing 4.5 million Americans, the plaintiffs, Baltimore, Chicago,...National News
A federal report conducted by the Office of the Inspector General (OIG) on Tuesday revealed how some hospices take advantage of Medicare payments and in some cases, are negligent of patients.
Hospice services can play an essential role in ensuring the comfort of terminally ill patients. It is a popular Medicare benefit and...National News
A sudden reversal of the Trump administration's decision to suspend risk adjustment payments just three weeks ago means the program paying billions to insurers in order to stabilize health insurance markets is back.
On Tuesday night, the Centers for Medicare & Medicaid Services (CMS) released a final rule that gave the...National News
Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma received a letter signed and supported by 28 medical organizations calling for CMS to re-evaluate and consider other options to deal with the decision to suspend risk-adjustment payments.
In the letter sent to Verma, the organizations pointed out the...Arizona News
Beginning October 1, the new Value-Based Purchasing (VBP) model begins and Skilled Nursing Facilities (SNFs) will automatically lose two-percent of Medicare funding.
SNFs have the opportunity to receive incentive payments from the Centers of Medicare & Medicaid Services (CMS) based on the quality of their care rather than the...National News
Kansas was one of five states that requested lifetime limits, the others are Arizona, Maine, Utah and Wisconsin.
As President Donald Trump took office, his administration announced a willingness to give states more flexibility in how they run their Medicaid programs, funded through a combination of state and federal dollars. The...National News
A request for information seeks public response to the proposed direct provider contracting payment model.
The RFI states a DPC model would aim to enhance the beneficiary-physician relationship by providing a platform for physician group practices to provide flexible, accessible, and high quality care to beneficiaries that have...National News
Posting of hospital prices, change meaningful use, long-term care hospital reimbursement and prices of immunotherapy drugs on the list.
Seema Verma, head of the Centers for Medicare and Medicaid Services, said the new requirement for online prices reflects the Trump administration's ongoing efforts to encourage patients to become...
