Last week, the Centers for Medicare and Medicaid Services (CMS) released a Framework for Health Equity at CMS, a frequently-used term by the agency that has been mentioned in nearly every initiative of President Joe Biden's Department of Health and Human Services (HHS).
According to the CMS blog post "Establishing the Framework for...CMS Rules
It's no secret that the Biden administration is planning to implement mandatory staffing levels in nursing facilities that are reimbursed through Medicare and Medicaid. In the most recent step to announcing this measure last Thursday, the Centers for Medicare and Medicaid Services (CMS) published new guidance on staffing measures tied to...
A new final rule is in effect as of July 1, 2022. CMS says that the Transparency in Coverage Final Rule is the first of several rules that will be met with stronger compliance enforcement in accordance with the No Surprises Act of 2021 and instead of targeting hospitals for the clear publication of potential prices for a range of...
The Centers for Medicare and Medicaid Services (CMS) has approved Colorado's plan to create a public insurance option through a Section 1332 innovation waiver. The "Colorado Option" will be offered in the Colorado Affordable Care Act Health Insurance Exchange beginning in 2023.
According to Healthcare Dive, the Colorado Option is the...CMS Rules
Earlier this year, President Joe Biden relaunched his Cancer Moonshot Initiative, which was initially established under the Obama administration to accelerate research into cancer prevention and cures. As part of the initiative, the Biden administration announced a new alternative payment model (APM) from the Center for Medicare and...
Last Wednesday, the Medicare Payment Advisory Commission (MedPAC) published its biennial report to Congress which included recommendations to streamline alternative payment models (APMs) within the Medicare program. It also recommended a strategy to improve accuracy in Medicare Advantage (MA) payments and correct a major contributor to...
Following the devastating report from the Arizona Auditor General in May, Arizona lawmakers held ADHS interim director Don Herrington's feet to the fire for nearly three hours last Thursday, searching for answers to the damning questions raised by the report.
The Arizona Department of Health Services is accused of not following...
As nursing homes across the country are grappling with staff shortages exacerbated by the COVID-19 pandemic, the Biden administration is considering a rule that nursing homes spend most of their Medicaid payments on direct care for residents rather than operations or capital improvements.
According to Modern Healthcare, the rule would...
The hospital price transparency rule, which was issued by the Centers for Medicare and Medicaid Services and went into effect on January 1, 2021, is largely being ignored by hospitals who would prefer to absorb any financial penalty than comply. CMS has only started to impose fines as of last Wednesday, according to an agency email, but...
Last Friday, the Centers for Medicare and Medicaid Services (CMS) published a report that reviewed the Medicare Supplementary Medical Insurance (SMI) Trust Fund for 2023 and determined that cost-savings from unexpectedly low Medicare Part B spending in 2022 could be recommended to drive premium cuts for Part B coverage next year.
The...National News
Value-based care is now a ubiquitous term across the medical industry, primarily led by Medicare payment models that prioritize quality of care above overall cost. But some are questioning the concept's utility and expanse over the Medicare market.
Legislation proposed in both the U.S. House of Representatives and Senate would...Arizona News
Arizona joined seven other states in a lawsuit initially filed by the state of Mississippi which asks a federal court to throw out an anti-racism rule by the Centers for Medicare and Medicaid Services (CMS). The final rule, released in 2021, reimburses physicians more when they create anti-racism plans.
The lawsuit was initially...National News
This week, value-based care (VBC) is frequently seen as a method for primary care providers to best serve patients, but increasingly more facets of the healthcare industry are investigating how technology, data analytics and value-based insurance design can help swap volume for value and deliver results for their patients.
Hospitals...Arizona News
Arizona may still have a chance to extend the time frame of postpartum Medicaid coverage from 60 days to one year after birth. The bill, SB 1272, passed the Arizona Senate and the House Health and Human Services Appropriations Committees with nearly unanimous support.
However, the bill has stalled while the Legislature negotiates the...
Last Friday, the Centers for Medicare and Medicaid Services (CMS) published a long-awaited final rule for Medicare Advantage (MA) that increases the agency's efforts to provide oversight to participating plans.
The rule includes new reasons for denying contracts or expanding contracts based on past performance. Modern Healthcare...
The No Surprises Act, a law that aims to protect Americans covered by private health plans from receiving surprise medical bills relating to emergency services or non-emergency services from out-of-network providers at in-network facilities, has been met with trouble since its implementation at the beginning of the year.
In February,...
Last Friday, April 22, 2022, the Centers for Medicare and Medicaid Services (CMS) issued a proposal to rectify a few of the issues many Americans face with Medicare enrollment.
The CMS press release says the proposed rule will implement provisions from the Consolidated Appropriations Act of 2021 and President Joe Biden's executive...
On Monday, the Centers for Medicare and Medicaid Services (CMS) published the Hospital Inpatient Prospective Payment (IPPS) and Long Term Care Hospitals (LTCH PPS) Proposed Rule, which will update Medicare fee-for-service payment rates and policies for inpatient hospitals and LTCHs for fiscal year 2023. The rule includes a 3.2% increase...
Last week was Black Maternal Health Week in the U.S., and with it came a number of announcements on support services through both public and private programs to improve health outcomes for pregnant or postpartum women of color and their children across the country and in Arizona.
In a short blog post for the Arizona Department of...
The BA.2 variant, also known as the "stealth Omicron," is now the dominant coronavirus version in the U.S. and more than 60 other countries. This week, Philadelphia became the first major city in the U.S. to announce that it would return to mandating masks in public spaces due to the spread of BA.2. Meanwhile, Arizona, the Centers for...