In March 2016, the Department of Health & Human Services (HHS) proposed the expansion of Medicare coverage for the Diabetes Prevention Program. The funding for this program comes from the...
The Centers for Medicare & Medicaid Services (CMS) has improperly paid more than $9 million for Medicare services among 481 unlawfully present beneficiaries during the years 2013 and 2014,...
The Centers for Medicare & Medicaid Services (CMS) announced in a press release late last week that the average Medicare Advantage monthly premium will be 13 percent lower in 2017 than before the...
This past January, the Centers for Medicare & Medicaid Services (CMS) announced a new funding opportunity for a program called the Accountable Health Communities (AHC) Model, which focuses solely...
Even though the Obama administration’s Patient Protection and Affordable Care Act assisted Medicare beneficiaries by attempting to end a drug coverage gap called the “doughnut hole”...
The ACA health insurance exchanges are facing greater risk now that a number of healthcare payers have decided to drop out of the marketplace. UnitedHealthcare was the first to announce its departure...
Audits conducted by the Government Accountability Office (GAO) reveal that up to 35 Medicare Advantage plans fraudulently billed the federal government for medical care provided to many of its elderly...
The Centers for Medicare & Medicaid Services (CMS) have recently begun implementing additional alternative payment models centered on episodes of care. CMS has proposed new rules for managing the...
Last month, Andrew Slavitt, Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), spoke at the American Medical Association 2016 Annual Meeting about new strategies to pay for...
The Medicare program may be in trouble with regard to its financial standing. The latest Medicare Trustees report found that the Hospital Insurance Trust Fund may be depleted in as little as six more...
The Centers for Medicare & Medicaid Services (CMS) is implementing a new payment and healthcare delivery system called the Oncology Care Model. This particular reimbursement program will involve...
The federal government is continually striving to reduce healthcare costs while providing better quality care for the patient community. Last week, the Centers for Medicare & Medicaid Services...
The major health payer Humana will be moving toward adopting additional bundled payment models that will serve Humana Medicare Advantage members. The payer will be partnering with four orthopedic...
The Medicare program will need to be reformed in order to account for the rising costs of running this major public health plan.As the baby boomer population gets older and more retired Medicare...
The Centers for Medicare & Medicaid Services (CMS) may be able to reduce healthcare spending by decreasing the number of hospitalizations, emergency room visits, and other expensive medical care...
The Centers for Medicare & Medicaid Services (CMS) has released its final rule detailing a timeline for the expansion of the Medicare Secondary Payer Web portal, which must meet the requirements of...
In order to ensure government funding isn’t used to pay erroneous or fraudulent medical claims, the Centers for Medicare & Medicaid Services (CMS) conducts risk adjustment data validation...
Skilled nursing facilities are an essential part of improving the health among the elderly and the disabled. However, some skilled nursing facilities and rehabilitation centers have taken advantage of...
The proposed changes to the Medicare Part B prescription drug program is finding opposition among multiple medical organizations. The Centers for Medicare & Medicaid Services (CMS) will need to...
Two months ago, the Centers for Medicare & Medicaid Services (CMS) announced a new proposed rule that would create new payment models meant to reimburse providers for assigning prescription drugs....
