payments
publication date
Finance
Health 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,...
Finance
Hospitals 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,...
Finance
CMS 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.
Finance
Medicare 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...
Finance
CMS Finalizes 2019 Inpatient Payment Rules
The policy pleased some providers by eliminating a controversial 25% policy for long-term care hospitals.
Finance
Some 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...
Finance
ACA Risk-Adjustment Payments Unfrozen
With a final rule, CMS restarted the permanent program it had halted over a federal judge's ruling.
Finance
CMS 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...