Last Friday, Representatives John Yarmuth (D-Ky.), Richard Neal (D-Mass.), Frank Pallone (D-N.J.) and David Scott (D-Ga.) introduced a bill, House Resolution 1868, that would eliminate the 2% Medicare sequester moratorium -- cuts that have been made across the board to all Medicare spending.
The bill also seeks to prevent the 4%...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...National News
As the Medicare Advantage (MA) open enrollment period is underway, some studies are indicating the reasons for the popularity of the MA program and the ways in which enrollees navigate between plans. Additionally, studies show that the Medicare program is likely underpaying hospitals for care provided to beneficiaries.
Data from the...Data Resources
In a new analysis, the Urban Institute found that coupling a Medicare buy-in with enhanced ACA tax credits would lead to the largest coverage gains.
Without the enhanced credits, a buy-in would not dramatically expand coverage or reduce costs, although it would help some people and could lower overall spending since payment rates...National Reports & Surveys
A new report comparing health outcomes for beneficiaries of Medicare Advantage (MA) and those on traditional fee-for-service Medicare found that MA beneficiaries spend far fewer days in skilled nursing facilities.
In Arizona, 2020 Medicare Advantage (MA) total enrollment was 574,475, with a 9% increase from 2019.
The report from...National News
Last week, Medicare Payment Advisory Commission (MedPAC) met to present its draft recommendations for 2022 payment rules. Their implication: hospitals, physicians, hospices, outpatient dialysis centers, and ambulatory surgery centers will be just fine financially less than two years after the onset of the pandemic.
According to...CMS Rules
Last Friday, the Centers for Medicare and Medicaid Services announced a final rule that makes changes to the Physician Self-Referral Law, or Stark Law, which prohibits doctors from referring patients to services or providers owned or employed by the referring physician. The law has caused issues for participants in value-based...Arizona News
In 2018 and 2019, CMS paved the way for supplemental benefits in MA plans by granting more flexibility for insurers. They have taken advantage.
A recent analysis from Milliman found that the number of Medicare Advantage plans across the country that offered at least one supplemental benefit increased by 64% from 2020 to 2021....National News
Major actors across the healthcare industry are anticipating changes in store for the future Biden-Harris administration as the president-elect signals a path towards stability after four years of erratic policy and attacks on the Affordable Care Act.
However, without a Senate majority, the president-elect will have some...Arizona News
Arizona is bracing for the impact of climbing positive rates all over the country, with ADHS encouraging Arizona residents to stay the course in order to keep cases from drastically increasing.
On date of publication, according to the Arizona Department of Health Services COVID-19 data dashboard, there were 1,044 new cases reported...Arizona News
As the highly anticipated presidential election fast approaches, the campaigns are working overtime to tout their contrasting positions on a variety of important healthcare issues.
As COVID-19 cases and hospitalizations rise across the country, no topic is more pressing than the pandemic. According to an NPR analysis relying on...CMS Rules
The new model now requires providers to get prior authorization (PA) before scheduling a non-emergent ambulance transport for a patient and pays ambulance services for taking patients to non-hospital facilities.
A ride in an ambulance can cost between hundreds and thousands of dollars depending on locations, services and the...National News
A new study by the RAND Corporation shows that hospitals are charging private insurance over twice as much as they get from Medicare's reimbursement rates for the exact same care. There are many indications that this gap is steadily increasing.
The gap itself isn't particularly new, but the growing gap between Medicare and private...CMS Rules
On Thursday, Sept. 3, the Centers for Medicare & Medicaid Services (CMS) launched Care Compare – an online consumer-facing database of provider quality information.
In January, CMS originally announced its plan to merge Home Health Compare with its seven other Compare sites. Agency officials said the goal was to create one...CMS Rules
On Aug. 31 CMS issued a proposed rule that aims to make innovative devices and breakthrough technologies more accessible to Medicare beneficiaries.
Once the Medicare Coverage of Innovative Technology final rule goes into effect, national Medicare coverage will begin on the date of a breakthrough device’s FDA market authorization and...Arizona News
A study designed to help Medicare officials determine if brain scans would be worth covering for Alzheimer’s patients determined that it would not be able to curb healthcare costs.
Advocates still hope they will be able to persuade the agency to support this type of testing but the agency determined it did not support an...Arizona News
Nursing homes, hospices, and inpatient psych facilities are getting some long overdue attention and can expect to see pay bumps come Oct. 1, albeit slightly less than previously proposed by CMS.
The final rule finalizes a 2.2% increase in overall payments to skilled nursing facilities in fiscal 2021. CMS says this means payments...Arizona News
As Arizona COVID-19 cases start to see some decline, the toll that the virus takes on individuals will be long lasting. Populations of vulnerable people both in the United States and internationally are more likely to experience more severe effects and higher rates of infection than more secure communities.
Last week, the Centers...National News
The 110-page document includes recommendations on climate change, criminal justice, the economy, education, immigration and healthcare. The task force was formed after Sanders left the race and represent a compromise from candidates positions during the Democratic primary campaigns. For example, in the healthcare section, there is no...CMS Rules
Those who are older, lower income, minorities and have chronic conditions are at higher risk for COVID-19.
On June 22, CMS released sought-after Medicare data (Jan 1 to May 16) on beneficiaries’ COVID-19 outcomes that found that more than 325,000 beneficiaries were diagnosed with COVID-19 during that time.
Almost 110,000 were...