Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

CMS

Proposed MA State Budget Targets Medicaid Program Funding

April 12, 2017 - The Massachusetts House of Ways and Means Committee approved a state budget for fiscal year (FY) 2018 that funds MassHealth, the state’s Medicaid program, through new tax revenues. The committee budget follows the one proposed by Governor Charlie Baker earlier this year. The Baker proposal called for a new employer-based fee that assists in paying for MassHealth spending. While the House-proposed...


More Articles

Proposed MA State Budget Targets Medicaid Program Funding

by Thomas Beaton

The Massachusetts House of Ways and Means Committee approved a state budget for fiscal year (FY) 2018 that funds MassHealth, the state’s Medicaid program, through new tax revenues. The committee budget follows the one proposed by Governor...

Medicare Fee-for-Service Program Improperly Paid $41.1B

by Thomas Beaton

Due to problems with oversight and contract issues, the Medicare Fee-for-Service Program wrongly made payments of $41.1 billion in 2016, according to a GAO report. Following an HHS report that initially found the inappropriate payments in the...

CMS: Payers May See 2.95% Rise in Medicare Advantage Revenue

by Thomas Beaton

CMS announced updates to the Medicare Advantage (MA) program and Part D Prescription Drug Program, including an expected 0.45 percent increase in revenues for payers and the potential for up to 2.95 percent in revenue growth. “Medicare...

CHIP Funding Cuts Would Leave 8M Low-Income Kids Uninsured

by Thomas Beaton

More than 8 million low income children living with chronic diseases would lose healthcare coverage and incur higher costs if CHIP funding is not extended beyond 2017, says new research from the Yale School of Medicine. In a study published in...

AHA Condemns CMS Rule for Medicaid Third-Party DSH Payments

by Thomas Beaton

The American Hospital Association expressed “deep disappointment” about a CMS final rule that will only include uncompensated care costs for covered Medicaid services in the calculation of hospital-specific DSH limits.   The...

WI Improperly Claimed $3M in Medicaid Drug Reimbursement

by Thomas Beaton

Wisconsin’s Department of Health Services failed to correctly invoice providers for over $3 million in Medicaid drug reimbursement, says the Office of the Inspector General (OIG) in a new report, leading to improper reimbursement from federal...

Medicare Limitations on Diabetes Supplies Endanger Patients

by Thomas Beaton

Medicare’s Competitive Bidding Program (CBP) may increase the risk of negative patient safety events or medication nonadherence for diabetics by limiting the variety of available diabetes testing supplies, finds a survey by the American...

HFPP Provides New Resource for Payers to Combat Opioid Abuse

by Thomas Beaton

A new 64-page report from the Healthcare Fraud Prevention Partnership (HFPP), a public-private partnership which includes CMS, gives payers resources that treat, educate, and develop improvements for combating opioid harm to patients. CMS has...

Price, Verma Push for Better State Control of Medicaid Programs

by Jacqueline Belliveau

As one of her first actions as CMS Administrator, Seema Verma collaborated with the Department of Health and Human Services (HHS) Secretary Tom Price to detail how the federal government plans to improve its state partnerships to enhance state...

AHA Questions CMS Medicare Advantage Risk Score Calculation

by Kyle Murphy, PhD

The American Hospital Association (AHA) has voiced concerns about the methodology the Centers for Medicare & Medicaid Services (CMS) intends to use to calculate risk scores for health plans under the Medicare Advantage and Part D prescription...

CMS Seeking Feedback on Pediatric Alternative Payment Model

by Thomas Beaton

The Centers for Medicare & Medicaid Services (CMS) recently issued a request for information seeking input on designing an alternative payment model focused on improving care quality and cost (APM) that specializes in pediatric care. The...

CMS Continues Extension of Transitional Coverage into 2018

by Thomas Beaton

The Centers for Medicare & Medicaid Services (CMS) has again extended its policy enabling states to permit health plans additional time to bring coverage into compliance with the Affordable Care Act. Jeff Wu, Acting Director of the Center...

CMS Solicits Payer Participation to Next Phase of CPC+

by Thomas Beaton

In support of second round of payer solicitation for Comprehensive Primary Care Plus (CPC+), The Centers for Medicare & Medicaid Services (CMS) has issued a list of frequently asked questions aimed at increasing payer support for the alternative...

GAO: Erroneous Medicaid Claims Data Pose Fraud Risk at CMS

by Thomas Beaton

Millions of people rely on long-term personal care services under Medicaid coverage, but significant gaps and errors in two major CMS data systems are creating significant opportunities for fraud and abuse.   A new report from the Government...

X

Sign up for our free newsletter:

Our privacy policy

no, thanks