Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Medicaid Payments

CMS Aims to Protect Medicaid Payments to Providers, Not 3rd Parties

July 10, 2018 - CMS recently proposed a rule change that would prohibit a state from diverting Medicaid payments away from providers unless the payment arrangement is explicitly authorized by statute. The proposed regulatory change to the Medicaid Provider Reassignment rule would remove text that permits a state to make payments to third parties on behalf of an individual provider. If finalized, the...


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Judge Voids CMS Rule Altering Medicaid DSH Payment Calculations

by Jacqueline LaPointe

A US District Court for Washington DC recently vacated a CMS final rule from 2017 that required third-party payments, including those from Medicare, to be used when calculating hospital-specific limits on Medicaid Disproportionate Share...

CMS Details $43B Drop in Medicaid Uncompensated Care Support

by Jacqueline LaPointe

In a recently proposed rule, CMS outlined a methodology for reducing Medicaid support for hospitals incurring significant uncompensated care costs starting in 2018. The rule would implement reductions of $1 billion per year in Medicaid...

OIG: CMS Not Reducing Medicare, Medicaid Improper Payments

by Catherine Sampson

In testimony submitted to House of Representatives Subcommittee on Oversight and Investigations, the Office of Inspector General (OIG) urged the Centers for Medicare & Medicaid Services to work with states to correct gaps in...

CMS Payment Reforms Mean Big Bucks for Medicare, Medicaid

by Catherine Sampson

Over the past month, CMS has announced finalized and proposed rules that would significantly impact payment policies in 2017 for managed care in Medicaid and the Children’s Health Insurance Program (CHIP) as well as Medicare hospice...

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