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989 Articles Matching "cms"

Insurers To Be Allowed To Prevent Drug Coupons From Applying To Annual Limit On Out-Of-Pocket Costs In Some Cases

Apr 20, 2019 , Kaiser Health News
CMS will allow insurers to implement the restrictions when there's a generic drug available to the patient. CMS argues that the rule would encourage patients to use generic drugs and lower drug...
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Changes To CMS Readmission Penalties Appear Effective In Addressing Unique Challenges Of Rural, Teaching Hospitals

Apr 17, 2019 , Kaiser Health News
The changes were made to address complaints from hospitals—safety-net hospitals in particular—that they are unfairly penalized in the readmissions program because of their complex patient case mix. For rural hospitals, their average penalties are estimated to decline from $55,268 to $53,633; while average penalties for teaching hospitals will drop from $287,268 to $283,461. Other news from CMS looks at accountable care organizations and primary care...
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Calif.-Based Sutter Health Agrees To $30M Settlement Over Allegations Of Submitting Inflated Diagnosis Codes To CMS

Apr 16, 2019 , Kaiser Health News
The Department of Justice alleges that Sutter and its affiliates submitted diagnosis codes that inflated the risk scores for certain beneficiaries in their care. “With some one-third of people in Medicare now enrolled in managed care...plans, large health care systems such as Sutter can expect a thorough investigation of claimed enrollees’ health status,” said Steven J. Ryan, special agent in charge with the Office of Inspector General for the U.S. Department of Health and Human...
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CMS's Seema Verma: Medicare for All is 'the greatest threat to innovation in healthcare'

Apr 10, 2019 laura.lovett@himssmedia.com (Laura Lovett), Mobile Health News
Verma also discussed the new AI Health Outcomes Challenge to speed up...
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New CMS ruling expands telehealth access to Medicare Advantage patients

Apr 09, 2019 laura.lovett@himssmedia.com (Laura Lovett), Mobile Health News
The new ruling will expand access geographical and plans will have more flexibility in payment...
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CMS Ignores Federal Judge Ruling To Approve Medicaid Work Rules in Utah

Mar 30, 2019 , Kaiser Health News
Work helps make people healthier, CMS chief Seema Verma said in approving Utah’s waiver request to tie government health benefits to employment or volunteer work. But Judge James Boasberg has said that isn’t the goal of...
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CMS May Expand Use Of A Procedure That Allows Doctors To Replace The Aortic Heart Valve Without Open-Heart Surgery

Mar 28, 2019 , Kaiser Health News
The proposed policy follows on the heels of recent studies that found the alternative way of replacing an aortic heart valve is safe and effective....
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CMS Issues Guidance To Help Determine If Assisted-Living Facilities Are Meeting Medicaid Funding Requirements

Mar 26, 2019 , Kaiser Health News
The new guidance all applies to group homes and home-based care settings. In other news, the number of providers participating in CMS' advanced bundled payment model has...
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CMS Report Reveals Interesting Statistics on Provider Participation in Quality Payment Program

Mar 26, 2019 , Healthcare Business News
March 25—CMS first annual report: Most clinicians avoid a negative payment adjustment under...
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March 25-29: What Events Are Coming in Health Care

Mar 22, 2019 , Healthcare Business News
March 21—Next week’s healthcare finance events and developments include the deadline to submit comments on changes to the CMS hospital overall star ratings....
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Pharmacy groups back CMS rejecting below-cost dispensing fees in Washington

Mar 20, 2019 , Drug Store News - Retail
Industry groups have voiced their support for the Center for Medicare and Medicaid Services' rejection of Washington state’s below-cost dispensing fee. The agency said the practice was inconsistent with federal Medicaid rules. Read More...
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Banner Health Children

Electronic Health Records: A Promising New Way To Fight the Opioid Epidemic

Mar 16, 2019 , Forbes
Electronic health records can equip health workers on the front lines with access to real-time data about patient prescribing patterns and is a key aspect of the CMS’s roadmap for combatting the opioid...
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Providers push back against conflict of interest concerns for Joint Commission, other accreditors

Feb 23, 2019 , Modern Healthcare Breaking News
Industry stakeholders told the CMS that they oppose banning accrediting organizations like the Joint Commission from providing consulting...
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Hospital Care Spending to Accelerate in Coming Years: CMS

Feb 23, 2019 , Healthcare Business News
Feb. 20—Hospital care spending is expected to accelerate over the coming 10 years as Medicare enrollments surge, more states expand Medicaid eligibility, and prices...
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Hospital Spending to Accelerate in Coming Years: CMS

Feb 22, 2019 , Healthcare Business News
Feb. 20—Hospital spending is expected to accelerate over the coming 10 years as Medicare enrollments surge, more states expand Medicaid eligibility, prices increase....
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CMS lost $84M in two years for ineligible nursing home stays

Feb 21, 2019 , Modern Healthcare Breaking News
The CMS pays millions of dollars a year to nursing homes for taking care of older adults who do not qualify for coverage, according to an investigation by HHS' inspector...
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Insurers, hospitals agree in telling CMS to keep 'silver-loading'

Feb 21, 2019 , Modern Healthcare Breaking News
Insurers, hospitals and state regulators are wary of the CMS ending "silver-loading" on Affordable Care Act...
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U.S. health spending to rise 5.5 percent per year over next decade: CMS

Feb 21, 2019 , Reuters
U.S. health spending is expected to grow at an average rate of 5.5 percent every year from 2018 over the next decade and will reach nearly $6 trillion by 2027 as more people become eligible for Medicare, a government health agency said on Wednesday....
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Healthcare spending will hit 19.4% of GDP in the next decade, CMS projects

Feb 21, 2019 , Modern Healthcare Breaking News
Healthcare spending growth will rise at an annual average of 5.5% over the next decade, slightly faster than in the past few years, due to the aging of the baby boomers and healthcare price growth, the CMS reported...
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U.S. Medicare plans to track CAR-T cancer therapy outcomes

Feb 16, 2019 , Reuters
The U.S. Centers for Medicare & Medicaid Services (CMS) on Friday proposed coverage of expensive CAR-T cell therapies at cancer centers that meet criteria including a registry or clinical study to monitor how well patients fare for at least two years after treatment....
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