AHCCCS seeks waiver and expenditure authority from CMS on two waiver demonstration projects.
The AHCCCS Housing and Health Opportunities (H2O) demonstration wants to improve and expand housing services and interventions for AHCCCS members who are homeless or at risk of becoming homeless.
With this waiver approval, AHCCCS will work...CMS Rules
The Medicare Payment Advisory Commission (MedPAC) agreed that the Department of Health and Human Services (HHS) must put together a consolidated group of alternative payment models in order to improve demonstrations.
From the commission's recommendation:
The Secretary should implement a more harmonized portfolio of fewer spending...CMS Rules
This week, the Supreme Court suspended hearings on Medicaid work requirements as other Trump era Medicaid policies come under fire. Plus, states aren't quite meeting reporting requirements and more reporting adjustments could be on the way.
The U.S. Supreme Court suspended its review of the Medicaid work requirements and removed the...National Reports & Surveys
This week The Centers for Medicare & Medicaid Services announced that it is lifting a suspension on hospital survey activities that was implemented during this winter's surge in COVID-19 cases and hospitalizations. An immediate resumption of survey activities for all complaints is allowed once more.
Background:
On Jan. 20 of...National News
Despite impassioned criticism from the hospital industry and a lawsuit from the American Hospital Association, CMS finally implemented its long-delayed hospital transparency rule on January 1, 2021. Multiple reports suggest that now, hospitals' are resisting complying with it.
The CMS Rule requires hospitals to “establish,...Arizona News
The Centers for Medicare & Medicaid Services have announced the final list of participants approved to take part in CMS’ Emergency Triage, Treat, and Transport (ET3) Model - a payment model that aims to provide greater flexibility to ambulance care teams to address emergency health care needs of Medicare Fee-for-Service...Government
The American Rescue Plan is set to reduce health care costs, expand access to insurance coverage and address health care disparities. The Biden-Harris Administration is working to ensure that nearly everyone who buys their own individual or family health insurance through a Marketplace can receive a tax credit to reduce their premiums....National Reports & Surveys
The payment gap between independent and hospital-employed doctors is significant. The average gaps were $63,000 for primary care doctors, $178,000 for medical specialists and $150,000 for surgeons.
Based on Medicare claims data from 2010-2016, research found that the program's payments for doctors' work were $114,000 higher per...CMS Rules
On January 14, the Centers for Medicare and Medicaid Services (CMS) released the Notice of Benefit and Payment Parameters for 2022. This included a finalized user fee of 2.25% of premiums for insurers on the federally facilitated exchange. The rule also allows states to enroll eligible patients in the individual marketplace.
Insurers...National News
In the midst of a catastrophic pandemic and the start of a new presidential administration, there is both urgency and optimism in those looking to the future of healthcare in America. This week, two major reports were published highlighting how the country can and should improve American's health in the coming months and...National News
According to data from the Centers for Medicare and Medicaid Services (CMS), participation in the Medicare Shared Savings Program (MSSP) is down nearly 8%. In 2020, 517 accountable care organizations (ACOs) participated, but in 2021 only 477 will participate.
A CMS fact sheet on shared savings programs demonstrates that earned shared...Arizona News
A new lawsuit brought by AARP contends a CMS policy weakened enforcement of financial penalties for nursing homes and must be reversed to restore protections for nursing home residents.
The American Association of Retired Persons engaged the law firm Constance Cannon to file the lawsuit against CMS and outgoing HHS secretary Alex...CMS Rules
Last Friday, the Centers for Medicare and Medicaid Services (CMS) approved a final rule requiring payers to build application program interfaces to support data exchange and streamline prior authorization. Medicaid and the Children’s Health Insurance Program (CHIP); healthcare exchange plans are also required to comply with the...Arizona News
Today, Arizona reported 5,629 new confirmed cases of COVID-29, bringing the state total to 641,729 since the pandemic began. There were 191 new deaths reported and the total number of deaths is now 10,673. Deaths recorded today will be retroactively reassigned to the date the death occurred. Arizona's total percent positive is 13.4%....National News
A recently study shows that the Affordable Care Act reduced income inequality by 10% in the United States ahead of the potential for a Supreme Court opinion that could overturn the entire law. The incoming administration under President-elect Joe Biden has articulated every intention of strengthening and building on the ACA, but how much...Arizona News
As of January 1st, all hospitals are now required to disclose prices for basic items and services due to the Trump administration’s price transparency rule which was given the go-ahead by a U.S. appellate court just last week.
The rule aims to empower consumers by making hospitals report their prices in two ways. They must publish a...National News
Due to the COVID-19 pandemic, hospices had to quickly confront and adapt to constraints on providers and patient access. These challenges, coupled with some corrective policies and new opportunities through Medicare payment models mean that things are starting to heat up in the changing industry.
Looking forward to what is still yet to...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) released 20 new proposed measures for quality and efficiency measures under consideration. CMS reviews and updates all quality measures annually for its programs, reviewing and removing less relevant ones and proposing more innovative metrics.
From CMS Administrator Seema...CMS Rules
On Tuesday, the United States Court of Appeals for the District of Columbia ruled that the Department of Health and Human Services may continue with the hospital price transparency rule on January 1. The American Hospital Association requested an injunction against the 2019 final rule that will require hospitals to make their standard...CMS Rules
Last Wednesday, a United States District Court judge issued an injunction against the Centers for Medicare and Medicaid Services’ (CMS) Most Favored Nation drug pricing model for 14 days. The demonstration was set to begin on January 1, but the court ruled that the COVID-19 pandemic emergency was not sufficient to immediately finalize...
