FinanceHealth Plan Files Another Risk-Adjustments Lawsuit
The way CMS rolled out a technical clarification for the 2017 benefit year ran afoul of the Administrative Procedure Act,...
FinanceHospitals Shun Government's Stance on Medicare Appeals Backlog
In addition to requiring HHS to implement AHA-backed interventions, the court should order HHS to maintain its own current efforts,...
FinanceCMS Proposes Risk-Adjustments Fix for 2018
The proposal reflects a similar technical clarification CMS made last month in its rule for the 2017 benefit year.
FinanceMedicare to Eliminate Appeals Backlog Within 4 Years, HHS Tells Judge
That timeline may not be good enough, since the judge previously ordered HHS to clear the backlog by December 31,...
Finance'Self-Inflicted Wound'? Health Plan Accuses HHS of Risk-Adjustment Charade
The government's decision to unfreeze ACA risk-adjustment payments with a new final rule demonstrates 'just how specious' its pending claims...
FinanceCMS Finalizes 2019 Inpatient Payment Rules
The policy pleased some providers by eliminating a controversial 25% policy for long-term care hospitals.
FinanceSome Doctors, Patients Balk At Medicare's 'Flat Fee' Payment Proposal
Many doctors predict that the proposed payment changes would establish a financial incentive to see fewer Medicare patients.
Finance'Site-Neutral' Payments? Hospitals Unhappy with OPPS 2019
One observer praised CMS for 'picking a fight with powerful hospitals' in the agency's annual update to payment proposals for...
FinanceACA Risk-Adjustment Payments Unfrozen
With a final rule, CMS restarted the permanent program it had halted over a federal judge's ruling.
FinanceCMS May Be Restarting ACA Risk-Adjustment Payments
A bit of potential regulation CMS sent to OMB for review suggests the agency may be tweaking its formula to...