On Tuesday, the Centers for Medicare and Medicaid Services issued a final rule for the Calendar Year (CY) 2022 Medicare Physician Fee Schedule (PFS). The PFS includes policy changes for Medicare payments and Medicare Part B, and is the major mechanism for rate setting for the Medicare program as a whole. The PFS must remain budget...
Nationwide, community transmission of COVID-19 remains high and 77.8% of Americans over the age of 12 have received at least one dose of the COVID-19 vaccine. Over 190 million people have been fully vaccinated and 14.4 million have received a booster dose. In Arizona, over 8 million vaccine doses have been administered with 58.9% of...
Medicare Advantage is under pressure to demonstrate its cost-savings for the Medicare program following a report for the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) that suggests Medicare Advantage (MA) plans "may have inappropriately" leveraged chart reviews and health risk assessments to...
Cases of COVID-19 appear to be on the downward trend nationally, as the number of new cases on October 12 falls to 111,707. Last month at this time, the surge related to the Delta variant of COVID-19 was at its worst with a seven-day average of over 175,000 new cases per day. There were 1,938 new deaths related to the coronavirus on...
On October 5, there were 101,668 new cases of COVID-19 reported across the entire United States and 1,808 new deaths. At least 65% of Americans of all ages have received at least one dose of the COVID-19 vaccine and 56% are fully vaccinated. Transmission rates remain high nationwide, largely due to the spread of the more-contagious Delta...
This week, Congressional Democrats are sparring amongst themselves to bring President Joe Biden's infrastructure bill to a vote and the most public figure against the package as it stands now is Arizona's own Senator Kyrsten Sinema. What she wants is unclear, but what's in the balance includes closing a Medicaid loop hole and expansion...Arizona News
On Tuesday, the U.S. Department of Health and Human Services (HHS) announced an award of nearly $1 billion in funding for 1,300 health centers funded by the Health Resources and Services Administration (HRSA) Health Center Program.
The purpose of the funding is to supplement COVID-19-related capital needs, construction or renovation...
The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) published a study on September 23 that found 20 Medicare Advantage companies generated a disproportionate share of federal overpayments by manipulating chart reviews and health risk assessments (HRA) to drive up reimbursement.
Total...
The Biden administration announced last Friday that it would make available $25.5 billion in provider relief funding to offset revenue loss and higher expenses during the COVID-19 pandemic.
According to Fierce Healthcare, funding will be used for reimbursing smaller providers that generally operate on thin margins and to boost...
This week the number of children hospitalized with COVID-19 set a record with 1,900 pediatric cases in hospitals across the United States on Sunday night. The Delta variant's rapid spread is to blame, primarily among unvaccinated populations which include children under age 12.
Of all hospitalizations, children comprise just 2.4%...
The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) ran an audit on Aetna's Medicare Advantage (MA) business according to parent company CVS Health. The HHS OIG has cracked down on inaccurate adjustment scores submitted by MA plans including Humana and Anthem.
Aetna's MA reimbursement is...Arizona News
New data released by the Centers for Medicare and Medicaid Services (CMS) showed that more than 2.5 million people enrolled in health coverage on HealthCare.gov and state Marketplaces during the 2021 Special Enrollment Period (SEP), which will close on August 15th.
Enrollment increased by about 404,000 nationwide in July 2021....White Papers, E books, Reports and more
There were 1,361 new cases of COVID-19 reported in Arizona on Wednesday, June 28. There were two new deaths. 51.8% of Arizona residents have received at least one dose of the COVID-19 vaccine. Use of intensive care unit beds across the state rose substantially in the past week, 19% of ICU beds are now in use by COVID-19-related patients,...
Last Friday, President Joe Biden issued a broad-sweeping executive order to address issues of corporate consolidation across U.S. industries. One of the industries cited was hospitals, drawing criticism for "misguided intentions" from industry stakeholders.
President Biden directed the U.S. Department of Health and Human Services...Arizona News
The U.S. Department of Health and Human Services (HHS) through the Health Resources and Services Administration (HRSA) provided $398 million in funding through the Small Rural Hospital Improvement Program (SHIP) to 1,540 small rural hospitals for COVID-19 testing and mitigation; funding allocated by the American Rescue Plan.
State...
Last Friday, the U.S. Supreme Court announced it would hear arguments for American Hospital Association v. Becerra, a case that deals with cuts made by the Centers for Medicare & Medicaid Services (CMS) to the 340B Discount Drug Program.
The American Hospital Association (AHA) along with the Association of American Medical...
There were 769 new cases of COVID-19 in Arizona on Wednesday, bringing the state total to 894,875. There were six new deaths, the total is now 17,936. Almost 46% of Arizona residents are vaccinated against COVID-19. Only 8% of intensive care unit beds are in use by COVID-19 patients and 15% of ICU beds are available.
This...News
The Department of Health and Human Services Office of Inspector General found that the Centers for Medicare & Medicaid Services (CMS) lacked the authority to ensure that hospitals had appropriate emerging infectious disease preparedness plans in place during the COVID-19 pandemic.
The OIG conducted this audit to asses how CMS is...News
Better Medicare Alliance, a leading research and advocacy organization supporting Medicare Advantage, has announced the selection of health policy veteran and patient advocacy leader Mary Beth Donahue as President and CEO.
Donahue has had nearly a decade of leadership in public service at the U.S. Department of Health and Human...
