Medicare will save approximately $18 billion from alternative payment models run by CMS’ Innovation Center (CMMI) between 2017 and 2026, a $16 billion difference compared to predictions from the...
Weaknesses in HRSA oversight of the 340B drug pricing program may result in some hospitals receiving discounts when they are not eligible to participate, a new report from The Government Accountability...
Funding legislation aimed at keeping HHS and other non-Defense agencies running in fiscal year (FY) 2020 will also postpone $4 billion in Medicaid Disproportionate Share Hospital (DSH) payment cuts...
A rule proposed by CMS on Tuesday would enable greater transparency and oversight of Medicaid supplemental payments to providers, which have proliferated in the last couple of years.
The Medicaid...
Update 9/27/2019: The Senate passed a continuing resolution that would temporarily stop the implementation of Medicaid DSH payment cuts until Nov. 22, 2019.
CMS on Monday finalized a rule...
The American Hospital Association (AHA) and five other hospital groups urged a court on Wednesday to stop a Department of Homeland Security final rule that is likely to reduce the number of insured...
New York is overcoming the challenges of developing value-based payment models for pediatrics to bring value to the approximately 1.8 million children enrolled in its Medicaid program, according to a...
Hospitals that treat a large proportion of low-income and uninsured patients could face lower Medicaid disproportionate share hospital (DSH) payments following a recent appeals court decision.
Earlier...
States are struggling to implement effective provider enrollment screening processes to prevent Medicaid fraud, including fingerprint-based criminal background checks, according to a recent HHS Office...
Medicaid accountable care organizations (ACOs) have not grown as quickly as industry experts anticipated, according to a new report from Leavitt Partners.
ACOs with at least one Medicaid contract...
A new final rule from CMS prohibits states from paying a portion of Medicaid payments for providers to third parties, including unions for home health workers.
Released May 2, the Medicaid Provider...
Forty-eight states have implemented value-based reimbursement or care programs as of February 2019, representing a seven-fold increase compared to five years ago, a new Change Healthcare study...
The Medicaid and CHIP Payment and Access Commission (MACPAC) recently released its March 2019 report to Congress, which advises policymakers to roll out cuts to Medicaid disproportionate share hospital...
CMS recently announced that it will be awarding up to $64.6 million to 12 state Medicaid agencies to help develop Medicaid reimbursement and care delivery strategies for maternal opioid misuse...
State Medicaid programs are significantly lagging with the adoption of fully electronic claim submissions, claim reimbursements, prior authorizations, and other claims management processes, according...
CMS recently approved a five-year Section 1115 demonstration allowing New Hampshire to provide Medicaid reimbursement to more behavioral health facilities for substance use disorder treatment...
Healthcare industry heavy-hitters are partnering to form a new coalition that generally aims to “improve what’s working in health care and fix what’s not,” especially in...
WASHINGTON DC - The future of Medicaid involves providing value-based care at an affordable price for all beneficiaries in the program, Kaiser Permanente’s CEO Bernard J. Tyson told attendees at...
WASHINGTON DC – Social determinants of health has emerged as a major theme at America's Health Insurance Plans’ (AHIP) National Conferences on Medicare, Medicaid, and dual eligibles in...
In a 55 to 43 vote yesterday, the Senate confirmed Seema Verma as the next CMS Administrator, according to a New York Times article.
Verma, the founder, president, and CEO of a health policy...
