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Inside the 1,182-page Hospital Outpatient Prospective Payment System final rule

November 2, 2018


CMS has released a final rule to update Medicare's Hospital Outpatient and Ambulatory Surgical Center Payment Systems for calendar year 2019, which contains several policy updates to address payment differences between different sites of service.

Inside the 682-page Home Health Prospective Payment System final rule

November 2, 2018


CMS this week finalized a 2.2% payment increase for home health agencies in 2019, as well as a new Medicare reimbursement process that will take effect in 2020.

It's coming: 340B rule delayed 5 times to take effect in January, HHS says

November 1, 2018


HHS says a long-delayed rule that would penalize drugmakers that deliberately overcharge providers for drugs purchased under Medicare's 340B Drug Discount Program will take effect Jan. 1, 2019.

CMS releases new quality data for SNFs

November 1, 2018


CMS has posted new quality data for skilled nursing facilities (SNFs), which the agency says "can demonstrate how a SNF's performance on … quality measures compares to that of other SNFs, as well as to the national average."

How CMS wants to expand telehealth coverage in Medicare Advantage plans

October 30, 2018


CMS Administrator Seema Verma says the agency's newly proposed rule "would give Medicare Advantage plans more flexibility to innovate in response to patients' needs" by "allow[ing] additional telehealth benefits, which will promote access to care in a more convenient and cost-effective manner for patients."

Trump's plan to cut drug spending: Let Medicare Part B pay the same prices as international buyers

October 26, 2018


The Trump administration is considering testing an International Pricing Index model that would pilot three new initiatives intended to lower the prices of drugs covered under Medicare Part B.

Hospital-acquired conditions cost a lot money—and lives—in 2016, research finds

October 25, 2018


A research brief from IBM Watson Health shows 48,771 hospital-acquired conditions occurred in 2016, which resulted in billions of dollars in excess hospital costs and thousands of potentially avoidable deaths.

What providers like—and don't like—about CMS' proposal to overhaul MSSP

October 22, 2018


A few health care providers say they support some provisions of CMS' proposed rule to overhaul the Medicare Shared Savings Program, but many providers are voicing concerns.

On Trump's fall 2018 health care agenda: Medicare Part D changes, Medicaid premiums, and more

October 19, 2018


The White House and federal agencies this week released their fall regulatory agendas, setting the stage for new health care regulations for the Affordable Care Act's exchanges, Medicaid, Medicare, and more.

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