CMS: Regional spending is a better benchmark for ACOs
By
John Hall
Mar 04, 2016
The government hopes to encourage accountable care organizations to extend their participation in performance-based risk arrangements by offering a new way to include payments based on regional spending...
Lawmakers target SNFs’ big payer for fraud, waste cuts
By
Kimberly Marselas
Apr 08, 2018
A pair of Congressional subcommittees focused on oversight have banded together to examine ways to reduce Medicaid fraud and waste.
A post-acute common pay system possible, CMS says
By
James M. Berklan
Mar 01, 2012
Federal researchers believe a common evaluation and payment model for three types of post-acute care could be up and running in the not-so-distant future. The key might be patient acuity measures that...
New ACO designed to better serve dual eligibles strategy
By
James M. Berklan
Jan 06, 2017
The Centers for Medicare & Medicaid Services announced Dec. 15 it was starting an ACO pilot program aimed at beneficiaries enrolled in both Medicare and Medicaid.
Right-to-try gains support
By
John Hall
Apr 04, 2016
Congress is considering easing federal laws prohibiting terminally ill patients from trying unapproved experimental drugs as a last-ditch effort to extend or save their lives.
Fix flaws before changing nursing home pay: AHCA says
By
James M. Berklan
Aug 01, 2013
The Centers for Medicare & Medicaid Services should consider a higher market basket update for nursing homes due to improper calculations that could be costing providers, the American Health Care Association...
New bid may be underway to foster Medicaid block grants
By
James M. Berklan
Feb 05, 2019
The administration is considering sidestepping Congress to make another run at using state block grants to pay for Medicaid funding, according to a published report.
Providers rip huge backlog of therapy claims reviews
By
James M. Berklan
Jan 01, 2014
A provider-sponsored survey recently uncovered huge backlogs of therapy claim reviews for beneficiaries who exceeded the Medicare Part B caps limits.
Washington owes Medicaid programs $4 billion, govs say
By
James M. Berklan
Aug 02, 2011
With federal lawmakers trying to figure out ways to cut expenditures, balance the budget and reduce the national deficit, funding to states — and healthcare providers in particular — has frequently...
MedPAC begins working on unified post-acute pay plan
By
John Hall
Nov 05, 2015
The Medicare Payment Advisory Commission is devising a plan that would pay skilled nursing facilities, inpatient rehabilitation facilities, home health agencies and long-term care hospitals under a unified...