The government is publicly reacting to the disruption in healthcare services caused by the Change Healthcare cyberattack and subsequent extended outage, but tangible consequences for UnitedHealth Group have yet to emerge.
The House Energy and Commerce Committee met this week to discuss the attack, but according to Modern Healthcare,...
The Centers for Medicare and Medicaid Services (CMS) have taken the next step on the Medicare Prescription Payment Plan draft guidance, which is required by the Inflation Reduction Act of 2022 to advance President Joe Biden's plan to lower drug costs for seniors.
The draft guidance provides communication and education requirements for...Arizona News
The federal government is worried that procedural disenrollments are too high as the Medicaid redetermination process proceeds.
On Monday, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra published a letter requesting that states take advantage of allowances and flexibilities authorized by HHS in their...CMS Rules
Last Thursday, the Centers for Medicare and Medicaid Services (CMS) announced that it would reverse course on anti-amyloid treatments for Alzheimer's patients and cover Leqembi should it receive full approval from the U.S. Food and Drug Administration (FDA). June is Alzheimer's Awareness month.
Leqembi, produced by Biogen and Eisai,...News
The U.S. government has started holding talks with pharmaceutical manufacturers in compliance with the provisions of the Inflation Reduction Act (IRA) that allows Medicare to negotiate prices for some drugs.
The Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure announced at a health conference in...CMS Rules
Last week, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that aims to improve quality reporting for Medicaid and the Children's Health Insurance Program (CHIP).
According to the CMS press release, the rule would include mandatory annual state reporting of three new quality measures, called "Core Sets,"...National News
Over the weekend, Senate Democrats came together to pass the massive Inflation Reduction Act, which includes a proposal to give Medicare the power to negotiate certain drug prices, as well as a three-year extension of Affordable Care Act (ACA) subsidies to insurers in the form of tax credits that were initially passed as part of the...
Last week, the Centers for Medicare and Medicaid Services (CMS) released a Request for Information (RFI), seeking comment on ways to improve Medicare Advantage and make the program more equitable, affordable and sustainable.
Medicare Advantage (MA) has been under great scrutiny lately, for policies on prior authorization, the adequacy...
The Direct Contracting payment model, devised under President Donald Trump's Center for Medicare and Medicaid Innovation (CMMI), grows more controversial as it has ended up in the crosshairs of Congressional progressives. But some Democrats and industry advocates support the payment model remaining on the table.
Early this month, more...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) announced a new proposed rule that takes aim at prescription drug costs in Medicare Advantage (MA) and Medicare Part D plans. The agency said the rule would reduce out-of-pocket costs for beneficiaries and improve price transparency as well as "market competition in the Part D...CMS Rules
Last week, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that included changes to the physician fee schedule (PFS) and changes to payments for Medicare Part B. The agency also announced an increase in Part B beneficiary premiums due in part to the authorization of the controversial Alzheimer's drug Aduhelm,...
On Wednesday, September 29, there were 3,388 new cases of COVID-19 reported in Arizona and 39 new COVID-19-related deaths. Deaths are reported by actual date of death. For intensive care unit beds, only 8% remain available statewide, with 30% of ICU beds occupied by COVID-19 patients.
This information can be found on the Arizona...
On September 7, 2021, there were 301,138 new recorded cases of COVID-19 in the United States. There were 2,226 COVID-19-related deaths. Of the total U.S. population, 63.2% have received at least one dose of the vaccine.
This information comes from the New York Times interactive COVID-19 data tracker.
Children and COVID-19
The...
Spending per beneficiary is growing faster in Medicare Advantage (MA) and private plans than traditional Medicare and Part D prescription drug plans, according to the MedPAC analysis.
Modern Healthcare reports that the spending disparity has experts concerned, considering that Medicare Advantage enrollment is surging, currently...National News
Last week, the Centers for Medicare and Medicaid Services (CMS) announced it completed its audit of the many alternative payment models (APMs) offered through the Centers for Medicare and Medicaid Innovation (CMMI) in order to develop and strengthen a more coherent path forward to value-based insurance design. This week, CMS, providers...National News
The Centers for Medicare & Medicaid Services (CMS) is looking forward for the potential for alternative payment models this week, and wants to leverage the potential of value-based care to support the Biden administration's quest for health equity for marginalized communities.
CMS has spent the past several months...CMS Rules
The Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-term Care Hospital Prospective Payment System (LTCH) received a new final rule from the Centers of Medicare and Medicaid Services (CMS) this week. The rule helps providers by dropping a requirement that would have forced hospitals to disclose their contract terms...CMS Rules
The Centers for Medicare & Medicaid Services (CMS) included provisions to expand reimbursement for telehealth services for mental and behavioral health care in the proposed 2022 Physician Fee Schedule released Tuesday. The proposal includes paying providers for audio-only services.
Telehealth use was widely expanded by CMS...CMS Rules
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on Monday that will expand the home health value-based purchasing (HHVBP) model, which was originally developed by the Center for Medicare & Medicaid Innovation (CMMI) in 2016. The rule also includes updates to the Medicare Home Health Prospective Payment...National News
It's no secret that of all the industries hard hit by COVID-19, skilled nursing and long term care were two of the hardest hit.
A study released on Tuesday by the inspector general of the Department of Health and Human Services found that four in ten Medicare beneficiaries who lived in nursing homes last year had or likely had...
