StrategyFewer ACOs Join Medicare Shared Savings Program, But More Take Downside Risk
The drop comes in the first enrollment start-date since CMS overhauled the program to hasten ACOs' downside risk.
StrategyWaiver Checklist: CMS Details How States Could Sidestep ACA Provisions
The tools offer greater detail on how states might make the most of four waiver concepts the administration released last...
FinanceMedicare Advantage Overbills Taxpayers By Billions A Year As Feds Struggle To Stop It
Officials have known for years that some Medicare Advantage plans overcharge for treating serious medical conditions they cannot prove their...
FinanceCMS Proposing Bundled Payment Model for Radiation Oncology
Participation would be mandatory for certain geographic areas during the model's projected five-year timeline.
New Final Rule Expands Access to HRAs
Feds say the new rule will benefit 800,000 employers, and more than 11 million employees and their families, including 800,000...
StrategyWonky Supreme Court Ruling on Medicare DSH Formula to Affect More Than Money
Moving forward, the government will have to complete notice-and-comment rulemaking for a broader set of its decisions.
Prior Authorization Bill Expected in Congress This Week
The legislation would set standards for Medicare Advantage plans.
FinanceRobin Hood To Rescue Of Rural Hospitals? New Math Promised On Medicare Payments
A federal proposal targets a long-standing and contentious regulation known in Washington simply as the 'wage index.'
FinanceMedicare's 'Primary Care First' Program Has Its Skeptics
The initiative is too focused on cutting hospitalizations and doesn't have enough money for doctors, critics say.
Clinical CareBaylor St. Luke's Files Corrective Action Plan with CMS
The hospital made public a CMS on-site inspection that detailed unsanitary and dangerously inadequate disinfection efforts with patient rooms, and...
CMS Issues New Guidance on PBM Up-Charging
Feds spell out how 'spread pricing' is calculated in medical loss ratios.
StrategyMedicare Just Invited More Competitors Into Value-Based Primary Care
Even as some important questions remain unanswered, the CMS Primary Cares Initiative is generating a lot of excitement. Observers say...