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How CMS wants to ease Medicare Part D plans' transition to proposed rebate rules

April 9, 2019


If CMS moves forward with proposed changes to eliminate certain prescription drug rebates in Medicare and Medicaid plans, the agency will launch a two-year demonstration program to ease Medicare Part D plans' transition.

Why dentists are turning to medical insurance for reimbursement

April 5, 2019


Faced with low reimbursements—or flat-out denials—from dental insurers, dentists are learning to bill medical insurers for some of the services they provide.

CMS finalizes MA payment bump, risk-adjustment changes for 2020

April 2, 2019


CMS on Monday finalized payment and policy changes for Medicare Advantage and Medicare Part D plans for the 2020 coverage year.

Democrats want an investigation into Verma's spending on outside GOP consultants

April 2, 2019


A group of Democrats on Friday called on HHS' Office of the Inspector General to launch an investigation into CMS Administrator Seema Verma's use of federal funds to pay for outside Republican communications consultants to help shape her public image, after a Politico investigation revealed CMS has spent millions of dollars on contracts with external consultants.

Most children's hospitals can avoid the value-based care revolution. So why is this hospital taking the plunge?

April 1, 2019


Although value-based care models are optional for children's hospitals, Dayton Children's Hospital is choosing to take on value-based financial risk.

CMS proposes significant changes to TAVR program requirements. Here's what you should know.

March 28, 2019


CMS on Tuesday proposed a set of policies that would make it easier for providers to meet surgical volume requirements to launch a transcatheter aortic valve replacement program and receive Medicare and Medicaid reimbursement for the procedure.

EConsults are becoming more popular in health care, but there's still some unknowns

March 28, 2019


A growing number of primary care doctors are replacing in-person specialist consults with electronic consultations—a practice that can "free up capacity in crowded health systems" and reduce wait times for other patients, according to health economist Austin Frakt.

The entire ACA should be struck down, DOJ argues in 'stunning' reversal

March 26, 2019


The Department of Justice in a legal filing Monday said a federal appeals court should strike down the entire Affordable Care Act as unconstitutional, changing its previous position that the court should only strike down parts of the law.

Clinician participation in MACRA's QPP exceeded CMS' goals, new report shows

March 25, 2019


The number of clinicians who participated in MACRA's Quality Payment Program in 2017 exceeded CMS' initial goal, according to a report the agency released Wednesday.

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