April 18, 2018
A coalition of consumer groups, health care insurers, and unions are urging CMS to re-issue a final rule intended to stop dialysis facilities and other third parties from steering Medicare-eligible patients with end-stage renal disease into individual market plans in instances when the facilities or third parties either directly or indirectly have a financial interest in doing so.
April 12, 2018
House Speaker Paul Ryan's (R-Wis.) announcement that he will not seek re-election in November is raising questions about whether Congress will achieve Ryan's long-sought goal to overhaul federal entitlement programs, such as Medicare and Medicaid.
An HHS Office of Inspector General report finds the federal government recovered $4.20 for every $1 spent through the Health Care Fraud and Abuse Control Program during fiscal years 2015 through 2017.
April 11, 2018
The Congressional Budget Office report states that "health care costs per beneficiary are projected to grow faster than the economy over the long term, contributing to growth in spending for Medicare and Medicaid in particular."
April 9, 2018
Adam Boehler, the founder and former CEO of Landmark Health, beginning this week will serve as the new deputy administrator and director of CMS' Center for Medicare and Medicaid Innovation.
CMS says, starting April 1, it will reimburse Medicare providers a total of $395,380 for administering the gene therapy cancer treatment Yescarta to outpatients, meaning some beneficiaries could have to pay a nearly $80,000 co-payment for the drug.
A draft recommendation that the Medicare Payment Advisory Commission approved last week calls for Congress to lower Medicare payments by 30% for off-campus, 24-hour hospital emergency departments (EDs) in urban areas that are located within six miles of an on-campus hospital ED.
April 4, 2018
New research suggests opioid prescriptions dropped in states where medical marijuana is legal—suggesting some U.S. residents might use marijuana to treat their pain as an alternative to opioids.
April 3, 2018
CMS in 2019 will increase Medicare Advantage plan payments by 3.4% and set new pharmacy limits for Medicare Part D beneficiaries deemed at risk of opioid misuse.
An Avalere analysis finds accountable care organizations (ACOs) participating in the Medicare Shared Savings Program increased federal spending by $384 million from 2012 to 2016, but observers question whether the CMS data analyzed accurately represent ACO performance.
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