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...News
The proposed rule for Year 3 of the Quality Payment Program (QPP) may boost participation and cut paperwork for eligible clinicians. Proposal adds ten new quality measures and dumps dozens of "low value" measures.
Providers, healthcare organization executives, association heads, and other stakeholders have until September 10 to...
CMS considers compelling acceptance of risk in the voluntary Medicare Shared Savings Program.
National Association of ACOs (NAACOS) released results from a survey of 82 participating ACOs about assuming risk and future participation plans for Medicare Shared Savings Program (MSSP) Track 1 ACOs. Answers to a key survey question show...
The new model may save the Medicare program more than $180 million by keeping beneficiaries healthy and averting new cases of diabetes.
According to CMS, Medicare spends more than $104 billion every year treating patients with this preventable disease.
The Medicare diabetes prevention program was launched in 2012 as a small,...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
Currently, researchers have access only to Medicare claims data for the fee-for-service program.
Release of Medicare Advantage data will provide a more comprehensive view of care provided to Medicare beneficiaries, said Verma at last week’s Health Datapalooza conference in Washington. Health Data Management quotes CMS Administrator...National News
Annual prospective pay rules are good news for skilled nursing facilities, hospices, inpatient psychiatric facilities and inpatient rehab facilities.
As well as increases in rates of payments, the Centers for Medicare and Medicaid Services proposes reductions in a variety of regulatory burdens. A listing of proposed changes can be...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...
CMS Administrator Verma announced on Tuesday several new initiatives for interoperability.
For data to flow freely, she said there would an overhaul of meaningful use, and the full ballroom at the HIMSS18 global conference in Las Vegas broke into applause.
HealthcareIT News reports Verma said in a...
In a Washington Post opinion piece, the CMS Administrator shares her vision.
Americans are among the most generous people in the world. While this nation was founded on the pursuit of a shared dream, the moral pledge of the American people has been to never leave behind our most vulnerable fellow citizens.
Our aim is...Arizona News
Trump administration to permit requirement to work if states seek it.
The Arizona Daily Star reports Arizona is one of 10 states that have submitted applications to add work requirements for the government health insurance program for low-income people.
The state’s Medicaid program, called the Arizona Health Care Cost Containment...National News
A major shift in the 50-year-old program, the guidelines will set the conditions for allowing states to add work requirements to their Medicaid programs, bringing a conservative twist to the health insurance program for the poor.
The Hill reports the changes represent the vision of Seema Verma, the administrator of the Centers for...
Early in December Arizona indicated intent to file a waiver, it has now been submitted to CMS.
The Section 1115 waiver requests CMS to permit work requirements and a five-year lifetime limit to Arizona's Medicaid program. If CMS approves the waiver, residents of Arizona who qualify for Medicaid and are between the ages of 19 and 55...
In spite of obstacles, more than 8.8 million signed up through the federal marketplace.
The Centers for Medicare and Medicaid Services said more than 8.8 million people have signed up in the 39 states served by the federal HealthCare.gov website.
That compares to 9.2 million last year in the same states — or 96 percent of the...Arizona News
She spoke to the plenary session of the National Association of Medicaid Directors (NAMD) Fall Conference in Arlington, Virginia.
Verma unveiled new CMS policies that encourage states to propose innovative Medicaid reforms, reduce federal regulatory burdens, increase efficiency, and promote transparency and accountability. A CMS...National News
The new approach aims to streamline the measures hospitals and physician practices must report on, focusing on those most essential to quality of care and improved outcomes.
Healthcare IT News quotes Administrator Seema Verma:
We need to move from fee-for-service to a system that pays for value and quality – but how we define value...National News
CMS' 2018 updates to the Quality Payment Program (QPP) regulation generated a response from the physician group.
The letter gave CMS a meticulous review of the agency's work. Some of the issues that are of critical importance to family physicians -- many of them related to the Merit-based Incentive Payment System (MIPS) -- were...National News
HHS Secretary Tom Price and CMS Administrator Seema Verma have access to powerful tools.
HHS can help states combat the problems of raising rates and shrinking individual marketplaces. Here are four ideas that HHS and the states can explore and expand:
Expand state reinsurance options
Allow innovative pilot plan designs for high...