Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

HHS

CMS: Payers Will Have More Time to File 2018 Health Plan Rates

August 15, 2017 - Payers still debating how uncertainty over cost-sharing reduction (CSR) subsidies will alter their insurance prices now have more time to submit 2018 health plan rates, CMS announced in a letter to insurers. While the letter says there's no plan to not to pay out CSRs, CMS will extend the deadline to submit insurance rates by three weeks to a final date of September 5th. The extension...


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CMS Approves State Capitated Medicaid Program in Florida

by Thomas Beaton

Florida received CMS approval to operate a state capitated Medicaid program and a low-income pool (LIP) to improve care for uninsured individuals, the federal agency announced. The state submitted a request to extend Florida’s Managed Medicaid...

DoJ Charges 412 in Medicare Fraud Schemes Totaling $1.3B

by Thomas Beaton

The Department of Justice (DoJ) announced the largest ever healthcare enforcement action in the history of the federal agency took place when the Medicare Fraud Strike Force (MFSF) charged 412 defendants for Medicare fraud losses totaling $1.3...

Increasing Competition Can Reduce Prescription Drug Prices

by Thomas Beaton

Reducing prescription drug prices for payers requires market-based solutions that increase competition and deregulate federal drug policies, the Pharmaceutical Care Management Association (PCMA) wrote in a letter to HHS secretary Tom Price.  ...

Medicare Hospital Insurance Trust Fund Depleted by 2029

by Thomas Beaton

A statement released by HHS and CMS’s Medicare Board of Trustees (MBT) indicates that the Medicare Hospital Insurance Trust Fund is likely to be depleted by the year 2029. The report suggests that the difference between Medicare income...

HHS Approves Alaska 1332 Waiver for State Reinsurance Program

by Thomas Beaton

Alaska will be able to move ahead with its plans to implement a state reinsurance program under a  1332 State Innovation Waiver, HHS confirmed this week.   The Alaska Reinsurance Program (ARP) will attempt to stabilize the state’s...

WI Medicaid Waiver Adds Drug Testing, Behavior Incentives

by Jesse Migneault

The Wisconsin Department of Health Services (DHS) will submit a section 1115 Medicaid waiver for the 2018 enrollment period that aims to add drug testing, healthy behavior incentives, and premium payments for certain beneficiaries. The waivers...

KY Medicaid Awarded for Exceeding Quality, Patient Care

by Jesse Migneault

Kentucky’s Anthem Blue Cross and Blue Shield Kentucky Medicaid has received an award from the National Committee for Quality Assurance (NCQA) for its Medicaid managed care plan.  The award recognizes the plan’s service and clinical...

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...

HHS Launches Webpage Detailing ACA Repeal Actions

by Thomas Beaton

HHS created a new online resource that highlights the regulatory and administrative actions the federal department has taken for an Affordable Care Act (ACA) repeal. HHS believes that these actions are necessary to relieve burdens of the...

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...

Tom Price: American Health Care Act CBO Score is Inaccurate

by Thomas Beaton

HHS Secretary Tom Price, MD, released a statement that decried several findings from the Congressional Budget Office’s (CBO) score of the American Health Care Act (AHCA). The CBO estimates that over 14 million Americans will lose health...

HHS Offers Waivers for Health Insurance Exchange Stability

by Jacqueline Belliveau

The Department of Health and Human Services (HHS) recently encouraged states to apply for State Innovation Waivers as a way to stabilize the health insurance exchanges and boost consumer access health plans and services. States should particularly...

HHS Secretary Price Voices Support for House ACA Repeal

by Thomas Beaton

The Secretary of the Department of Health & Human Services Secretary (HHS) penned a letter to the two House Republicans behind the American Health Care Act praising the new legislation that would replace the Affordable Care Act. “On...

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