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CMS announces an estimated $180M settlement of long-delayed Medicare claims

June 21, 2019


After two years of negotiations, CMS on Monday announced new voluntary options for Inpatient Rehabilitation Facilities to settle disputes over denied Medicare Part A claims.

Alexander, Murray just released updated legislation to address 'surprise' medical bills. Here's what made the cut.

June 20, 2019


Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) on Wednesday formally introduced a wide-ranging bill to address so-called "surprise" medical bills that would establish a benchmark provider payment rate for out-of-network services, instead of the arbitration process favored by hospital industry groups.

Lawmakers still split on how to address 'surprise' medical bills

June 19, 2019


Lawmakers and stakeholders during a Senate Health, Education, Labor, and Pensions Committee hearing Tuesday agreed steps must be taken to address so-called "surprise" medical bills, but they were divided over the best way to do so.

This new coalition is spending millions of dollars to target 'surprise' medical bills

June 12, 2019


A newly formed coalition of employers, health insurers, and a physician group is calling on Congress to establish a benchmark payment rate and implement other strategies to address so-called "surprise" medical bills.

Opioid suits lead Insys to file for bankruptcy—and other drugmakers could follow

June 12, 2019


Insys Therapeutics on Monday filed for Chapter 11 bankruptcy protection, just days after the drugmaker agreed to pay $225 million to settle allegations that it paid kickbacks to physicians to encourage them to prescribe its highly addictive opioid—and some observers say similar allegations could cause other drugmakers to follow Insys' lead.

CMS wants to know: How can it reduce clinicians' administrative burdens?

June 11, 2019


CMS on Thursday issued a request for information seeking new recommendations on how the agency can continue to help reduce administrative burdens on providers and lower health care costs.

Why 250K Medicare beneficiaries are about to be hit with an unexpected bill

June 10, 2019


An estimated 250,000 Medicare beneficiaries can expect to get bills for up to five months of premiums they likely thought already had been paid, but had not because of a "processing error" that occurred in January, according to the Social Security Administration.

SCOTUS just sided with hospitals over $4B in Medicare payments

June 4, 2019


The Supreme Court in a 7-1 decision has upheld a lower court ruling that CMS improperly changed Medicare's disproportionate-share hospital payment formula.

How CMS' new exact match policy could put hospital payments at risk

June 3, 2019


Hospitals have about one month to ensure their off-campus and outpatient facilities' addresses exactly match what CMS has on file or risk missing out on Medicare payments.

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