Tag: CMS

August 29, 2023

The Centers for Medicare & Medicaid Services (CMS) announced that the Medicare Shared Savings Program saved money for Medicare while continuing to support high-quality care. Specifically, the program saved Medicare $1.8 billion in 2022 compared to spending targets for the […]

July 28, 2023

The highly-anticipated data from the CMS is for the 18 states that renewed at least one cohort of Medicaid beneficiaries in April. Of those, almost 46% of beneciaries had their coverage renewed, while 22% of beneficiaries’ renewals are pending. Typically, […]

July 7, 2023

In 2018, Congress directed regulators to change how Medicare pays for home health services, shifting away from reimbursing for the number of therapy sessions and focusing instead on the complexity of care provided. Regulators also calculated a new 30-day episode […]

March 16, 2023

While Congress laid out the broad principles for Medicare to negotiate “maximum fair” prices for drugs, much of the process and details were left to the CMS to develop this year ahead of negotiations starting in 2024 for a first […]

February 27, 2023

The federal government’s ban on surprise bills took effect at the start of 2022 in effort to protect patients from being stuck with hefty medical bills when providers and payers fail to agree to pricing terms. To remove patients from […]

February 3, 2023

Medicare Advantage plan rates will increase by 2.09% next year, largely in line with analyst expectations but likely lower than payers had hoped. The 2024 Medicare Advantage and Part D Advance Notice released Wednesday also includes some technical changes to […]

January 30, 2023

In the final two months of 2022, the Centers for Medicare and Medicaid Services (CMS) released over 5,000 pages of new regulations and the U.S. Congress passed into law a 4,000-plus page omnibus spending bill that had over 1,000 pages […]

November 18, 2022

The rule requires hospitals, ambulatory surgery centers, nursing homes and other healthcare facilities to ensure staff are fully vaccinated or risk losing Medicare and Medicaid funding. In January the Supreme Court upheld the mandate in a 5-4 decision, ruling the […]

October 20, 2022

On August 1, 2022, the Centers for Medicare & Medicaid Services (CMS) announced final changes to its payment program for acute care hospitals in 2023. The FY 2023 Inpatient Prospective Payment System (IPPS) final rule also included policies for the […]

September 7, 2022

Reforming the Medicare physician payment system is a top priority for the AMA. The group successfully lobbied Congress to delay a round of 4% cuts to Medicare rates until 2023 that were set to take effect at the end of […]

May 6, 2022

Expanding Medicare coverage of telemedicine during the pandemic increased odds of use among minority populations and patients in metropolitan areas, a new study found. The study, overseen by Johns Hopkins University, was published in Health Affairs and looked at 30 […]

May 4, 2022

Telemedicine skyrocketed after CMS relaxed restrictions on geographic location and allowed providers to bill for virtual patient visits at the same rate as in-person visits during the public health emergency. The Medicare telemedicine coverage waiver issued early 2020 also reduced […]

April 25, 2022

The Trump administration in last January approved a decadelong extension of Texas’ Medicaid waiver, just days before President Joe Biden was sworn into office. The state applied for ane tension early, as the waiver was scheduled to expire in fall […]

April 8, 2022

Leaders of the Food and Drug Administration (FDA) and the Centers for Medicare & Medicaid Services (CMS) sought to present a united front a day after CMS approved narrow Medicare coverage of the Alzheimer’s disease drug Aduhelm. FDA Commissioner Robert […]

March 7, 2022

The Biden administration needs to do more to address the impact of the pandemic on Medicare Advantage enrollee risk scores, a key payer group charges. The insurance lobbying group AHIP said in comments on the MA and Part D advance […]

December 15, 2021

U.S. healthcare spending skyrocketed in 2020 as the federal government invested significantly in response to the COVID-19 pandemic, according to new data from the Centers for Medicare & Medicaid Services (CMS). CMS’ Office of the Actuary released its annual report […]

December 6, 2021

Early decisions from a pair of federal judges have several hospitals and health systems pumping the brakes on workforce COVID-19 vaccination requirements as they wait to see how the Biden administration’s nationwide mandate will play out in the courts. Thursday, […]

December 2, 2021

The Biden administration is asking for feedback on how to improve health equity in the organ transplant system and boost access to dialysis services. The Centers for Medicare & Medicaid Services (CMS) released a request for information Wednesday to seek […]

November 29, 2021

Dozens of House representatives have taken issue with the Centers for Medicare & Medicaid Services’ (CMS’) recent repeal of a Trump-era rule granting expedited Medicare coverage to breakthrough medical devices. In a letter penned to CMS Administrator Chiquita Brooks-LaSure last […]

August 6, 2021

Accurate and up-to-date healthcare provider data is integral for health plans to guide their members towards the most appropriate care and for providers to deliver that care efficiently – ultimately reducing cost, improving quality of care, and improving outcomes. Collecting […]