As the national mental health crisis worsens, in part due the COVID-19 pandemic for patients and healthcare workers alike, behavioral healthcare integration is at the top of industry priorities. This week, health care payers of all stripes are innovating solutions to covering costs.
The Medicare Payment Advisory Commission (MedPAC)...National News
The Medicare open enrollment season is in full swing and is expected to further entrench Medicare Advantage's market penetration. Traditional Medicare and Medicare Advantage are both working to incentivize enrollment and stabilize their representation in the market.
Over a third of Medicare beneficiaries intend to stick with whatever...CMS Rules
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...
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...
The Biden administration has pledged to provide Americans with better in-roads to health coverage and to even the playing field for people at a systemic disadvantage from receiving adequate healthcare. This week, a number of policy decisions highlight the administration's commitment to these goals in Medicare coverage, health equity and...National News
Last Thursday, the U.S. Senate voted to delay statutory cuts to Medicare. There were two types of cuts, the first -- 2% -- were delayed until March and relate to Medicare sequestration, which is an automatic reduction of federal spending to enforce a balanced budget. Sequestration of 2% was initially delayed by the Coronavirus Aid,...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,...CMS Rules
Last week, President Joe Biden announced that he would roll back a controversial Trump-era rule that would have required green card applicants and other immigrants to demonstrate that they would have health insurance upon arrival to the U.S. The so-called "public charge" rule would have allowed the government to deny visa applications if...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) issued a final rule making changes to the Comprehensive Care for Joint Replacement (CJR) payment model last week. The final rule extends the payment model for three performance years for participating hospitals and allows for CMS to test modifications to the model.
The final rule...National News
A new bill in the senate, proposed by Senator Debbie Stabenow (D-MI) and other Senate Democrats would allow people under 65 and over 50 to buy into Medicare. WEAU 13 reports that 27% of adults approaching retirement age are not confident that they can afford health insurance, and more than 25% have difficulties navigating insurance...CMS Rules
Last Friday, the Trump administration announced two interim final rules in a last-ditch effort to fulfill the president’s campaign promises of lowering drug prices for seniors. Many of President Trump’s prior efforts were blocked by litigation or lost momentum during the rule making process. With eight weeks left in his presidency,...CMS Rules
Medicare beneficiaries will see a 7 percent increase in monthly premiums and annual deductibles for 2020 Part B coverage, which takes care of physician services, outpatient hospital services, explicit home health services and durable medical equipment.
The Centers for Medicare and Medicaid Services (CMS) announces the rates for...
Medicare patients and providers have long struggled with interpreting the three-day rule. Last month, a trial began after a class action lawsuit on behalf of patients was brought against the Centers for Medicare & Medicaid Services (CMS) because of the rule.
What is the three- day rule? How does it work? Why hasn’t this...