December 5, 2018
The American Hospital Association, the Association of American Medical College, and three independent health systems in a lawsuit argue that the Trump administration does not have the authority to implement a new site-neutral payment policy under Medicare.
CMS data show nearly 11,000 skilled nursing facilities will see their Medicare payments decrease in fiscal year 2019 as a result of poor performance under CMS' new Skilled Nursing Facility Value-based Purchasing Program.
December 4, 2018
CMS says more than 1,500 U.S. hospitals will receive bonus payments in fiscal year 2019 under Medicare's Value-Based Purchasing Program.
November 30, 2018
HHS has finalized a long-delayed ceiling price and civil monetary penalties rule for Medicare's 340B drug discount program that is slated to take effect Jan. 1, 2019.
November 29, 2018
CMS' new online tool shows the national average that Medicare pays both ambulatory surgical centers and hospitals for certain procedures, as well as the national average copayment a Medicare beneficiary without supplemental insurance would pay for the procedures.
HHS' Office of the Inspector General in a new report identifies "material inaccuracies" in data CMS used to calculate the Medicare Area Wage Index, which the agency uses to adjust hospitals' Medicare payments.
November 28, 2018
CMS' proposed rule seeks to eliminate barriers that prevent Medicare Part D and Medicare Advantage enrollees from accessing lower-cost drugs by giving Part D plans more flexibility to use formulary management tools, such as prior authorizations and step therapy.
November 27, 2018
Earlier this year, the Trump administration asked for recommendations on ways to ease anti-kickback laws that limits where physicians can refer Medicare beneficiaries. Providers and lobbying groups responded in force—but some legal experts say any move to ease existing laws could increase fraud and abuse.
November 21, 2018
A report from the Senate's Permanent Subcommittee on Investigations found the price of EVZIO, a drug designed to reverse an opioid drug-related overdose, increased from $575 per unit in 2014 to $4,100 per unit in 2017.
November 20, 2018
CMS says the 2018 Medicare Fee-For-Service (FFS) improper payment rate decreased from 9.51% in fiscal year (FY) 2017 to 8.12% in FY 2018, marking the second consecutive year the agency's improper Medicare FFS payment rate is less than 10%.
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