The Centers for Medicare and Medicaid Services (CMS) still has $1.6 billion to collect in Medicaid overpayments, news revealed through Office of Inspector General (OIG) audits. A new December OIG report explains that CMS's timely recovery of overpayments helps to confirm that federal funds are being used effectively and...Arizona News
Last week, the Centers for Medicare and Medicaid Services (CMS) released four State Empowerment and Relief waiver concepts for states to utilize under the Affordable Care Act’s (ACA) section 1332. CMS aims to encourage innovation and reduce burdens with the waivers, an action commended by Health and Human Services (HHS) secretary Alex...Arizona News
On Monday, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to lower prescription drug costs for beneficiaries by making changes to Medicare Part D. The proposal could give insurers negotiating powers on drug prices by offering an expectation that plans would implement broader use of prior authorization (PA)...Arizona News
Last week, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma released an update to her Merit-based Incentive Payment System (MIPS) original performance evaluation published in May. The November 8 blog post revealed 93 percent of participants merited a positive payment adjustment for their 2017...National News
On Monday, the Centers for Medicare and Medicaid Services (CMS) along with the Department of the Treasury released revised guidance giving states more regulatory power with innovation waivers under the Affordable Care Act (ACA).
The way CMS evaluates and accepts waivers regarding innovation for each state's individual market is...Arizona News
The personal information of approximately 75,000 people was breached last month after a government run healthcare sign-up system was hacked. The Centers for Medicare and Medicaid Services (CMS) announced the news on Friday, Oct. 19 just a few weeks before the Affordable Care Act exchange opens up for open enrollment.
On Monday, the Centers of Medicare and Medicaid Services (CMS) proposed a rule that would require drug companies to list drug costs in their direct-to-consumer advertisements. In an initiative to inform beneficiaries of drug costs, the agency anticipates it will help minimize their out-of-pocket costs along with Medicare and Medicaid...
The Office of the Inspector General (OIG) recently discovered $5.7 billion in unreasonable and unnecessary payments to inpatient rehabilitation facilities (IRFs) after a sample audit. The review was prompted by Medicare spending of about $7 billion on IRF stays in 2013, leading the OIG to question the payment system.
The OIG sampled...Arizona News
In May, a final rule from the Centers for Medicare & Medicaid Services (CMS) opened the doors for Medicare Advantage (MA) insurers to offer long-term care benefits to members. About 7.5 percent of MA plan enrollees in 2019 may have access to in-home support services or extra benefits, according to CMS officials.
In a speech...Arizona News
On Friday, September 28, The Centers for Medicare & Medicaid Services (CMS) announced that Medicare Advantage (MA) premiums will decrease by six percent, on average, in 2019. Additionally, plan choices and new benefits are expected to increase as MA enrollment reaches new highs.
According to a statement from CMS, more than 36...Arizona News
Tennessee is now the fourth state to introduce a work requirement proposal for Medicaid enrollees, joined by Alabama, Michigan, and Virginia who also posted their proposals this month.
The waiver would require enrollees to seek or maintain work in order to keep Medicaid benefits. The state's requirements will specifically focus on...National News
On Monday the Centers for Medicare and Medicaid Services (CMS) issued a proposal to relieve healthcare providers of Medicare's unnecessary compliance burdens.
According to the CMS press release, the updates would save healthcare providers approximately $1.12 billion annually.
CMS Administrator Seema Verma attributed this...Arizona News
The Centers for Medicare and Medicaid Services (CMS) on Thursday, Aug. 16 announced key changes to the Medicaid Review Process that are designed to significantly reduce approval times for state Medicaid agencies.
Sometimes a simple request can mean enduring several months of review. CMS said its now...National News
Four major U.S. cities are suing President Trump and his administration for deliberately attempting to ensure the Affordable Care Act (ACA) fails, thus violating the president's constitutional duty to execute laws faithfully under the Take Care Clause.
Representing 4.5 million Americans, the plaintiffs, Baltimore, Chicago,...National News
A federal report conducted by the Office of the Inspector General (OIG) on Tuesday revealed how some hospices take advantage of Medicare payments and in some cases, are negligent of patients.
Hospice services can play an essential role in ensuring the comfort of terminally ill patients. It is a popular Medicare benefit and...National News
A sudden reversal of the Trump administration's decision to suspend risk adjustment payments just three weeks ago means the program paying billions to insurers in order to stabilize health insurance markets is back.
On Tuesday night, the Centers for Medicare & Medicaid Services (CMS) released a final rule that gave the...National News
The Trump administration's Medicare proposals could mean big changes how physicians are compensated. A standard cold and Stage 4 cancer would offer doctors identical payments regardless of a patient's medical complexities.
Essentially, the government would pay one of two rates depending on if the patient is new--higher rate--or...National News
Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma received a letter signed and supported by 28 medical organizations calling for CMS to re-evaluate and consider other options to deal with the decision to suspend risk-adjustment payments.
In the letter sent to Verma, the organizations pointed out the...National News
Insurers claim the Trump administration's decision to withhold billions of dollars in risk adjustment payments could result in higher premiums for millions.
It was confirmed Saturday that $10.4 billion in payments to insurers under Obamacare is suspended due to a court's ruling over the risk adjustment program in New Mexico....National News
To crack down on Medicaid fraud and waste, The Centers for Medicare & Medicaid Services (CMS) will conduct audits of state programs and private Medicaid managed care plans as part of an initiative announced Tuesday, June 26.
CMS administrator Seema Verma attributed these plans to the agency's reformation of Medicaid for "a...