The Department of Justice (DoJ) recently announced the indictment of Tenet Healthcare Corporation’s former senior vice president of operations for his alleged participation in a healthcare fraud...
Massachusetts-based Beth Israel Deaconess Medical Center and Lahey Health announced plans to pursue a healthcare merger earlier this week.
The two healthcare systems have debated a potential...
Providers interested in participating in the Next Generation Accountable Care Organization (ACO) model in 2018 can now submit a letter of intent to CMS, according to the alternative payment...
Through healthcare fraud cases and settlements in 2016, Department of Health and Human Services (HHS) and Department of Justice (DoJ) initiatives returned over $3.3 billion to the federal government...
CMS recently announced that the federal agency selected over 359,000 clinicians to participate in four of the federal agency’s alternative payment models in 2017.
The new participants will be...
Avoidable hospitalizations among dual-eligible long-term care facility residents dropped by 31 percent between 2010 and 2015 largely because of value-based care programs, CMS recently stated in an...
In an official blog post, CMS recently touted its success with improving primary care provider productivity by giving practices in the Comprehensive Primary Care (CPC) program more multi-payer claims...
A federal court recently denied a Department of Health and Human Services (HHS) request to reconsider the four-year timeline developed to eliminate the Medicare appeals backlog at the administrative...
New Jersey’s Department of Health and Human Services may have to repay the federal government almost $95 million after the Office of the Inspector General (OIG) recently found that the state agency...
CMS recently unveiled a Medicare-Medicaid accountable care organization (ACO) model that will allow participating providers in the Medicare Shared Savings Program to take on accountability for Medicaid...
The Department of Veterans Affairs (VA) will now give some advanced practice registered nurses full practice authority in order to boost care access and quality of care. However, certified registered...
Eligible clinicians now have more opportunities to earn value-based incentive payments by participating in the Advanced Alternative Payment Model track of the Quality Payment Program in 2018, according to...
In effort to increase healthcare transparency, CMS recently added two new healthcare organization Compare websites and updated performance data for existing hospice care, hospital, and physician Compare...
The Department of Health and Human Services (HHS) must eliminate the Medicare appeals backlog at the administrative law judge review level by Dec. 31, 2020, a federal judge recently decided.
The most...
CMS recently proposed a rule that would limit a state’s ability to create or increase a Medicaid reimbursement structure for hospitals, physicians, and nursing homes that pays providers for services...
The MassHealth program in Massachusetts will received about $1.8 billion over the next five years to implement value-based reimbursement structures in the statewide accountable care organization (ACO)...
Large hospitals averaging approximately 260 staffed beds were more likely to receive a negative value-based reimbursement adjustment under a hospital-specific Medicare program in 2016, according to a...
CMS recently released a final rule that will reduce Medicare reimbursement to home health providers by $130 million, or 0.7 percent, in 2017. Lower Medicare spending on home health services will stem...
End-stage renal disease (ESRD) and dialysis providers can expect a 0.73 percent increase in total payments compared to last year under new Medicare reimbursement rates, CMS recently announced. Medicare...
Starting in January 2017, Vermont will implement the first voluntary all-payer accountable care organization (ACO) model that will align ACO design across Medicare, Medicaid, and commercial payers,...
