CMS
publication date
Payer
The First Year of GA's Medicaid Work Requirement Is Mired in Red Tape
Georgia is the only state that requires certain Medicaid beneficiaries to work to get coverage.
Payer
ACA Enrollment Platforms Suspended Over Alleged Foreign Access to Consumer Data
CMS told Speridian Global Holdings that they were suspended after the agency identified 'a serious lapse in the security posture.'
CFO
Providers Are Fed Up With Medicare Advantage
Sanford Health is the latest system to drop its MA plan with Humana. Why the trend?
Payer
A Lack of Parity In Parity? A National Recovery Month Spotlight
Coverage for substance use disorder varies but the view from 2024 looks so much brighter.
Payer
Will 2025 Mark a Turning Point for Medicare Advantage?
When is growth not enough to keep payers happy?
Payer
Feds Killed Plan To Curb Medicare Advantage Overbilling After Industry Opposition
Newly released court depositions show CMS officials repeatedly cited concerns about pressure from the industry.
Revenue Cycle
States Are Tackling Prior Authorization Reform
While progress at the federal level is slow, state legislatures are passing bills aimed at improving the prior authorizations process...
Payer
The Many Faces of UM: The Next Two Decades
Utilization management has the power to perform many jobs. Will it?
Payer
Biden Administration Blocks Two Private Sector Enrollment Sites from ACA Marketplace
The unusual step comes as CMS is under the gun to curb unauthorized enrollment and switching of ACA plans by...
Innovation
New Program Tests SNF-Level Care at Home
Mass General Brigham is using a state grant to test an advanced care at home model for patients in need...
Payer
Medicare Advantage in 2024: Enrollment Update and Key Trends
The growth in Medicare Advantage enrollment is due to a number of factors, including the availability of plans that charge...
Revenue Cycle
CMS Finalized The IPPS Rule With a 2.9% Rate Increase. Here's Who Could be in Trouble.
Despite the slight bump, rural and underserved facilities may see significant decreases in their reimbursement payments.