Medicare

Medicare Claims Data Show Health Disparities in COVID-19 Patients

by Jill McKeon

Researchers found significant disparities in Medicare fee-for-service beneficiary spending in an analysis of Medicare claims data relating to COVID-19, according to a Centers for Disease Control and...

Chiquita Brooks-LaSure Becomes Next CMS Administrator

by Jacqueline LaPointe

The Senate has confirmed Chiquita Brooks-LaSure to lead the Centers for Medicare & Medicaid Services (CMS) by a vote of 55 to 44. Brooks-LaSure is the first Black woman to lead the agency...

CMS to Reweight MIPS Cost Performance Category for 2020

by Jill McKeon

CMS announced it will be reweighting the cost performance category under the Merit-Based Incentive Payment System (MIPS) from 15 percent to zero percent for the 2020 performance period to provide...

Court Orders HHS to Recalculate Medicare DGME Payments

by Jill McKeon

HHS unlawfully changed the weighting factors assigned to residents and fellows for Medicare Direct Graduate Medical Education (DGME) payments, according to a recent opinion from the US District Court...

CMS Finalizes Changes to CJR, Joint Replacement Medicare Model

by Hannah Nelson

CMS issued a final rule that makes changes to the Comprehensive Care for Joint Replacement (CJR) model, including revised episode definition and payment methodology, to adapt the model to changes in...

Providers Try to Stave Off Looming Medicare Spending Cuts

by Jacqueline LaPointe

UPDATED The American Medical Association (AMA) has urged Congress to prevent pending Medicare spending cuts triggered by the latest COVID-19 relief plan. In a March 16 letter to House Speaker...

CMS Starts Primary Care First Value-Based Payment Model Second Wave

by Hannah Nelson

The Centers for Medicare and Medicaid Services (CMS) has opened applications for the second cohort of the Primary Care First (PCF) value-based payment model which seeks to drive down costs and increase...

2% Hospital Reimbursement Hike, Other 2022 MedPAC Recommendations

by Jacqueline LaPointe

In its annual March report to Congress, the Medicare Payment Advisory Commission (MedPAC) has recommended a 2 percent increase in Medicare hospital reimbursement rates in 2022 and no update for...

CMS Boosts Medicare Reimbursement for COVID-19 Vaccinations

by Jacqueline LaPointe

UPDATED 03/16/21 CMS has significantly increased Medicare reimbursements rates for the administration of new COVID-19 vaccines in an effort to accelerate rollout, according to a new...

New Bill Seeks to Extend Medicare Sequester Moratorium

by Jacqueline LaPointe

UPDATED 04/16/2021 A bill is seeking to prevent across-the-board spending cuts triggered by the latest COVID-19 relief package, including the 2 percent Medicare sequester reduction, known as...

Providers Blast Medicare Spending Cuts in COVID Relief Package

by Jacqueline LaPointe

The latest $1.9 trillion COVID-19 relief package includes several provisions advantageous to healthcare providers but will leave them to face significant Medicare spending cuts in the future. Passed...

Low-Value Care Spending Slows as Medicare Pushes Value-Based Care

by Hannah Nelson

Low-value care spending among fee-for-service Medicare recipients dropped slightly from 2014 to 2018. However, two of the three services that make up the majority of low-value healthcare spending,...

Groups Want Medicare Sequester Moratorium Through End of PHE

by Jacqueline LaPointe

Healthcare organizations from across the care continuum are calling on Congress to act before the moratorium on the 2 percent Medicare sequester expires on Mar. 31, 2021. Congress has paused the...

Biden Administration Inherits Slew of Medicare Regulatory Changes

by Jacqueline LaPointe

Nearly all Medicare providers have been impacted by at least one COVID-19 pandemic-related regulatory change, the Commonwealth Fund reports. Under the Trump administration, there were 244 Medicare...

CMS Cost Reporting Delayed as Hospitals Question Proposed Changes

by Jacqueline LaPointe

CMS has delayed the filing deadline for cost reports by two months for most healthcare organizations because of the ongoing COVID-19 pandemic. The agency posted in a COVID-19 Frequently Asked...

Seema Verma Resigns as CMS Administrator Ahead of Biden Inauguration

by Jacqueline LaPointe

Seema Verma announced on her Twitter today that she is resigning as CMS Administrator in preparation for a new Medicare and Medicaid leader coming in next week under the Biden...

CMS Defines “Reasonable and Necessary” Medicare Coverage

by Jacqueline LaPointe

CMS has codified how it defines “reasonable and necessary” coverage for items and services that may be covered under Medicare Parts A and B in a new final rule. The rule finalized on Jan....

Most Physicians Prefer Single-Payer Option Over Medicare For All

by Jacqueline LaPointe

Providing affordable health insurance coverage is a top goal for physicians and most believe healthcare can achieve that through a single-payer option, a new survey reveals. The final installment of...

Variation in Medicare Spending Narrows as Top-Spenders Cut Costs

by Jacqueline LaPointe

Healthcare spending variation has been a major challenge for the industry, but a new study in Health Affairs has found that the gap between high- and low-cost regions is getting smaller based on...

ACOs Can Grow Value-Based Payment in Medicare, But Changes Needed

by Jacqueline LaPointe

With Medicare spending growing at an unsustainable rate, the Medicare Payment Advisory Commission is advising Congress to accelerate the transition to value-based payment, using accountable care...