Because hospitals, health systems, and providers are on the frontlines of treating and covering patients with COVID-19, the Centers for Medicare and Medicaid Services (CMS) decided to extend the...
Amid the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) announced the suspension of data collection and reporting linked to several key quality programs.
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CMS has issued guidance for private health plans regarding coverage for coronavirus diagnostic testing and relevant products and procedures.
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CMS has finalized its Medicare Advantage and Part D rates, including finalizing the disputed Medicare Advantage end-stage renal disease (ESRD) payment rule without changes.
CMS anticipates a slight...
The Department of Justice (DOJ) has initiated a lawsuit against the major payer Anthem for allegedly submitting inaccurate Medicare Advantage chart reviews to CMS for risk adjustment.
“Anthem...
COVID-19 demonstrates why block grants are a faulty method of controlling Medicaid spending, experts from the Robert Wood Johnson Foundation argued.
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America’s Health Insurance Plans (AHIP) committed to supporting provider partners, specifically hospitals and health systems, as they combat coronavirus.
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Updated 3/27/2020: This article has been updated to reflect the most recent CMS section 1135 Medicaid demonstration waiver approvals.
On March 23, ten days after coronavirus was declared a...
On March 22, the Trump Administration released materials to guide Medicaid and CHIP programs to effectively orient and pursue coronavirus relief efforts.
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CMS has approved Florida’s Section 1135 waiver, allowing the state to avoid some of the administrative processes that may weigh down the escalating efforts against coronavirus.
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Medicaid expansion is key to securing national access to care for the new coronavirus and the federal government can and should support state programs for increasing COVID-19 coverage, according...
On March 13, the Trump Administration declared the spreading coronavirus (COVID-19) a national emergency. CMS immediately followed with various resources, including a factsheet from March 5 about...
Dual eligible beneficiaries who are in “aligned enrollment”—or are enrolled in both a dual eligible special needs plan and a Medicaid managed care organization under the same...
Reactions to the finalized interoperability rule have fallen predictably along industry lines, as payers and providers spurn the new rules but technology companies warm up to them.
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CMS has released guidance regarding how Medicare Advantage and Part D Plans can properly respond to the COVID-19 outbreak.
For more coronavirus updates, visit our resource page, updated twice...
With its new interoperability rule, CMS pushed ahead with the anticipated mandates, which direct payers to provide Patient Access application programming interfaces (APIs) and Provider Directory APIs,...
CMS has released the next phase of the 21st Century Cures Act on interoperability.
The rule, which was expected to be announced at HIMSS20 before the conference was canceled, supports the...
In its comments on the CMS advance notice for Medicare Advantage (MA) and Part D changes, the Medical Group Management Association (MGMA) urged CMS to pursue greater transparency in Medicare Advantage...
The US Chamber of Commerce is the most recent opponent to the CMS Medicaid Fiscal Accountability Regulation (MFAR), joining governors, providers, and payers in its disavowal of the rule’s...
The Government Accountability Office (GAO) has conducted the first review of state Medicaid eligibility determinations since the ACA’s implementation in 2014 and found that there were several...
