The Centers for Medicare and Medicaid Services (CMS) has issued a final rule that will increase the amount federal authorities can recoup from Medicare Advantage organizations (MAOs) that were overpaid due to incorrect diagnostic coding.
The Medicare Risk Adjustment Data Validation (RADV) final rule means that CMS will also stop...
The Biden Administration’s nursing home reform plan was unveiled earlier this month, with emphasis on improving quality of care. The plan includes more than 20 initiatives, with minimum staffing requirements a top priority. The plan was met with discontent from industry stakeholders who assert the implication that nursing home quality...
A new bill introduced by Representatives Suzan DelBene (D-Wash.), Peter Welch (D-Vt.), Darin LaHood (R-Ill.) and Brad Wenstrup (R-Ohio) looks to reverese Trump-era modifications to the Medicare Accountable Care Organization (ACO) program and restore higher cost savings to participating providers while removing some of the risk. The bill...National News
The Biden administration has elected to discontinue the Next Generation Accountable Care Organization Model (Next Gen) at the end of 2021, to the disappointment of the National Association of Accountable Care Organizations (NAACOS). The program for accountable care organizations was originally expected to end at the beginning of the year...Arizona News
As the Biden Administration prepared for its new role leading U.S. health policy and Arizona became the new national poster child for the ravages of the COVID-19 pandemic, political lines were drawn and Governor Ducey listed his budget priorities.
Last week, U.S. Health and Human Services Secretary Alex Azar and CMS Administrator...CMS Rules
CMS makes move to drive value-based reimbursement for cancer and chronic kidney disease (CKD) and end stage renal disease (ESRD) with a new final rule. The End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model uses value-based care payments to encourage the usage of home dialysis and kidney transplants. The new model also benefits...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...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...CMS Rules
A U.S. Department of Health and Human Services watchdog reported that Seema Verma, Centers for Medicare and Medicaid Services chief, mishandled millions of dollars in federal contracts that ultimately benefited friends and former Trump officials.
The Office of Inspector General Report concluded Verma violated federal contracting...Arizona News
President Trump announced the formation of an independent commission last week to address the troubling number of coronavirus cases in nursing homes across the country. The Coronavirus Commission for Safety and Quality in Nursing Homes will conduct a comprehensive assessment of the nursing home response to the pandemic.
The...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) is expanding its accelerated and advanced payment program for Medicare providers to support hospitals and doctors on the front lines of the rapidly spreading, global pandemic.
Taking advantage of the recently established Coronavirus Aid, Relief and Economic Security...Arizona News
Hospitals and providers participating in Medicare quality value-based purchasing programs received unprecedented relief on Sunday from a Centers of Medicare and Medicaid Services (CMS) announcement that relaxes reporting requirements and extends data submission deadlines.
The action is part of the Trump Administration's response...News
Three major hospital groups penned a letter, addressed to House Speaker Nancy Pelosi, urging Congress to suspend the mandated Medicare sequester for the duration of the pandemic.
Established by the Budget Control Act in 2011, the federal sequester cuts government spending by more than $1 trillion for the 2021 fiscal year and it would...National News
The Trump Administration’s recent push to tighten Medicaid eligibility is drawing national criticism. As the administration considers more frequent eligibility reviews, state Medicaid agencies are under increasing pressure to control costs and meeting new federal requirements is expensive.
Centers for Medicare and Medicaid Services...Arizona News
Hospital prices continue to be scrutinized as employer groups deem costs way too high and pressure from the Trump Administration to publish negotiated prices increases.
According to a Rand report, significant discrepancies were found between what private health plans pay for hospital services versus Medicare, highlighting that...CMS Rules
The final rule provides details on the requirements for making public discounted cash prices, payer-specific negotiated charges and de-identified minimum and maximum negotiated charges for at least 300 ‘shoppable’ services, publicly available in a consumer-friendly format effective January 1, 2021.
The Health & Human Services...National News
On Monday, the Centers for Medicare and Medicaid Services (CMS) followed up on President Trump's June 24th executive order which directed a slew of federal agencies to start working on healthcare transparency issues.
Trump's executive order directed the Secretary of Health and Human Services (HHS) to propose a regulation to require...Arizona News
In a speech given on Monday at the Better Medicare Alliance 2019 Medicare Advantage Summit, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma voiced concerns about the consequences a single-payer healthcare system including its impact on innovation with the elimination of private insurers.
Verma explicitly...National News
The Centers for Medicare & Medicaid Services (CMS) announced that 518 ACOs are approved to participate in the newly branded Medicare MSSP, Pathways to Success program July 1; just 40 are new to the program, less than the more than 100 new ACOs the program averaged in its first seven years.
The MSSP is the largest value-based...Arizona News
Scrutiny on healthcare policy is intensifying following recent warnings from House Democrats against Affordable Care Act (ACA) changes, citing an internal memo sent by Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma to Health & Human Services Secretary Alex Azar in August.
The memo from Verma...
