Medicare & Medicaid News

New CMS Payment Model Aims to Advance Nursing Facility Care

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The Centers for Medicare & Medicaid Services (CMS) recently announced an innovative funding opportunity to allow payment model testing within nursing care facilities. Originated to advance the...

Hospitals Dodge Financial Penalty with Medicare ACA Loophole

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According to the Affordable Care Act (ACA), hospitals demonstrating low quality measures face financial penalties under Medicare. However, due to a discovered loophole as confirmed within a...

CMS Adds Pilot Project Participants to Reduce Medicare Costs

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The Centers for Medicare & Medicaid Services (CMS) has announced over 2,100 acute care hospitals, skilled nursing facilities, physician group practices, long-term care hospitals, inpatient...

Does Improved Care Access, Insurance Coverage Stem from ACA?

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Can the Affordable Care Act (ACA) be considered a success? According to data analysis published in The Journal of the American Medical Association, the answer is a hearty yes. Although the time prior...

CRE Backs Reform Process of CMS Hospital Star Ratings System

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Is the Hospital Quality Star Ratings system released by the Center for Medicare & Medicaid Services (CMS) merely too problematic to be effective? According to the Center for Regulatory Effectiveness...

CMS Announces Final Rule Implementing Quality Care in SNFs

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Value-based payment and quality care continue to prove high on the Centers for Medicare & Medicaid Services’ (CMS) agenda. On July 30, the Centers for Medicare & Medicaid Services (CMS)...

Medicare, Affordable Care Act Spending Discussion Continues

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Medicare and the Affordable Care Act's (ACA) financial future is perhaps nothing more than a cyclone of ever-evolving opinions. A recent RevCycleIntelligence.com article, Will Medicare Part D...

Healthcare Reform Bill to Financially Support Mental Illness

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Lack of mental health care causes major financial issues, costing approximately $193 billion in lost earnings and productivity, according to a recent new release. On August 4, Senators Bill Cassidy, MD,...

Healthcare Spending to Rise Despite Lack of Patient Input

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Healthcare spending is expected to climb to enormous heights by 2024, according to a recent news release by the Citizen’s Council for Health Freedom (CCHF). According to Twila Brase, R.N and...

CMS, Rhode Island Announce New Medicare-Medicaid Care Model

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The Centers for Medicare & Medicaid Services (CMS) announced a partnering with the state of Rhode Island last Thursday to test a new model for supporting Medicare-Medicaid enrollees by advocating...

SNFs to Receive Funds Via Proposed Rural Healthcare Bill

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New legislation may be able to alleviate the healthcare and Medicare costs that have for so long caused issues regarding access to care in rural areas. Skilled nursing facilities (SNFs) may see an...

4,000 Healthcare Providers Receive $54M for HEDIS Excellence

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Physicians are demonstrating their continued dedication to advancing the quality of healthcare and helping Medicare Advantage members receive optimum treatment and are getting paid accordingly for doing...

4 Triumphs and Challenges in Medicare and Medicaid’s 50 Years

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After 50 years as laws, Medicare and Medicaid have seen several triumphs and challenges, making their marks on American healthcare from expanding low-income coverage to raising serious questions about...

July 31: Week That Was in Healthcare Fraud and Malpractice

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Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported...

Will Medicare Part D Prescription Drug Plans Stabilize?

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As Medicare – established along with Medicaid on July 30, 1965 – formally hits its 5-decade anniversary this week, the healthcare industry turns over a new financial leaf upon...

How Can Hospitals Refocus Cost Reduction, Payment Tactics?

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As hospitals consider various ways to strengthen their revenue cycle, they may be focusing on the wrong places while overlooking the right places. As the expansion of hospital acquisition and mergers...

NOTICE Act Helps Beneficiaries Understand Healthcare Costs

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In a unanimous vote, the Senate passed the Notice of Observation Treatment and Implication for Care Eligibility Act (the NOTICE Act) on July 27, according to the American Hospital Association...

Is Sustainability the Future of Healthcare Spending Growth?

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Healthcare spending growth is expected to increase throughout the next decade, according to newly released data from Health Affairs via the Centers for Medicare & Medicaid Services (CMS) Office of...

CMS Releases New Medicaid Enrollment, Medicare Coverage Data

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The Centers for Medicare & Medicaid Services (CMS) has released updated Medicare state-by-state enrollment numbers. Over 55 million individuals are covered via Medicare, says CMS. This number is 36...

NAMD Says Medicaid Managed Care Rule Restricts Healthcare Reform

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In response to the proposed regulations of Medicaid managed care, the National Association of Medicaid Directors (NAMD) submitted a list of comments to the Centers for Medicare & Medicaid Services...