Medicare & Medicaid News

Is Increased Medicaid Coverage the Chronic Disease Solution?

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What do Manhattan rents, Ferraris, college tuition, and chronic disease all have in common? They are all really expensive. What is especially problematic is that chronic diseases are not only very...

CMS Confirms More Affordable 2016 Medicare Part B Premiums

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Healthcare consumers’ wallets will apparently be a tad fuller next year. 2016 will not see a cost of living increase for those under Social Security, according to an announcement from the...

CMS Announces Two-Midnight Payment Cut Commentary Period

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A notice and accompanying commentary period released yesterday from The Centers for Medicare & Medicaid Services (CMS) examines the core issue behind slashing hospital inpatient payments by 0.2...

CMS Reports $2.4B in Healthcare Consumer ACA Premium Rebates

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Consumers are apparently receiving major bang for their buck, although not in relation to this week’s hard-to-miss Black Friday and Cyber Monday holiday sales brouhaha. Healthcare consumers have...

CMS Approves Outpatient Ambulatory Patient Experience Survey

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How can you best measure patient experience? Perhaps with a 37-question survey. The Centers for Medicare & Medicaid Services (CMS) has approved the administration of an Outpatient and...

CMS Announces Top 3 Volume to Value Medicare Payment Goals

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Patrick Conway, MD, MSc, Chief Medical Officer at the Centers for Medicare & Medicaid Services (CMS), is speaking out about the administration’s overarching goals for Medicare’s...

Is Data Collection too Burdensome in CMS Final Payment Rule?

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A new 311 page final rule from the Centers for Medicare & Medicare Services (CMS) aims to amend the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory...

How the Nursing Work Environment Affects Patient Outcomes

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Nurses play a significant role in advancing favorable patient and nurse outcomes, says a recent report and accompanying press release from Press Ganey. “As a key player on the front lines of...

How Successful is the ACA Really at Cutting Uninsured Rates?

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Misunderstandings swirl as the Affordable Care Act’s (ACA) ever evolving ability to reduce the number of uninsured adults is continuously called into question. The total number of adults who have...

GAO to CMS: State Medicaid Payment Flaws Hurt Transparency

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The reliability regarding tens of billions of dollars in states’ supplemental payments is being called into question this month by the United States Government Accountability Office...

GAO Reports Inadequate CMS Federal Exchange Coverage Control

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Insufficient and inadequate policies and procedures from the Centers for Medicare & Medicaid Services (CMS) require greater levels of federal control to maintain effectiveness, says a report from...

Healthcare Consumers Demand More Coverage Comparison Options

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A new pilot initiative involving a “Doctor Lookup” feature is now available for some healthcare consumers’ online perusal. Such a beta feature lets healthcare consumers compare...

Medicare Home Health Agencies Face Upcoming Payment Changes

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The Medicare home health prospective payment system (HH PPS) can expect payment changes next year, confirms an announcement from the Centers for Medicare & Medicaid Services (CMS). These...

Cigna-HealthSpring, UPHS Confirm Network Expansion Agreement

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Cigna-HealthSpring and The University of Pennsylvania Health System (UPHS) have announced new collaboration efforts to expand a 2016 network relationship agreement and provide supplementary resources...

CMS Final Rule Improves Medicaid Beneficiaries’ Care Access

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The Centers for Medicare & Medicaid Services (CMS) has released a final rule – effective on January 4, 2016 – that aims to advance the way covered services are measured and strengthen...

Expensive Hepatitis C Drugs Quadrupled Prescription Spending

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Healthcare spending for the privately insured has steadily increased over the last 5 years, confirms today’s fifth annual healthcare spending report from the Health Care Cost Institute...

CMS: It’s Quality Over Quantity with Value-Based Purchasing

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The ever familiar “Show me the money!” mentality only rings true in the case of quality over quantity regarding hospital payments, implies the Centers for Medicare &...

Medicare Advantage Members Report High Plan Satisfaction

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Medicare Advantage members confirm greater levels of plan satisfaction than those enrolled in commercial programs, says a 2015 Medicare Advantage Member Satisfaction...

HHS Backs Behavioral Health with $23M Grant Funding Efforts

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The Substance Abuse and Mental Health Services Administration (SAMHSA) – in partnership with both the Centers for Medicare & Medicaid Services (CMS) and the Assistant Secretary of Planning and...

CMS Releases Sec. Burwell’s Section 1115 Congress Report

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A report to Congress – The Secretary's First Annual Report on Transparency in the Review and Approval of Section 1115 Demonstration (Amendments to the Social Security Act (SSA) and...