Insurers rattled by Medicaid managed care’s big changes
By
John Hall
Jun 06, 2016
The government’s first major overhaul of the Medicaid Managed Care program in 14 years is unlikely to affect provider reimbursements, but insurers continue to take exception with one provision allowing...
OIG: Tougher 2016 probes
By
John Hall
Dec 04, 2015
Providers should expect more aggressive federal efforts to investigate healthcare fraud cases as the Department of Health & Human Services makes use of sophisticated data analytics in the coming year.
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...
No ‘midnight’ regulations?
By
John Hall
Mar 04, 2016
Stakeholders have until roughly mid-June to squeeze in any pressing new regulations during the current administration’s final year. But the Office of Management and Budget said it doesn’t expect...
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.
‘Illusion’ can raise costs
By
John Hall
May 04, 2016
In an effort to improve the use of medical treatments, a University of Pennsylvania Medical School professor is calling for more research to help doctors recognize and manage what some call a “therapeutic...
Analysis: PAC crucial to joint replacement bundled success
By
John Hall
May 04, 2016
Hospitals participating in a new Medicare bundled payment program for hip and knee replacements should partner with high quality post-acute care providers like nursing homes within the first 90 days following...
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...
Agencies seek feedback on quality measure reporting
By
John Hall
Feb 04, 2016
Nursing homes were allowed a 30-day window last month to give the Centers for Medicare & Medicaid Services a piece of their mind about the way the agency certifies and tests electronic health record products.
Groups tout payment plans; Pallone promises legislation
By
John Hall
Apr 04, 2016
Several organizations have weighed in on how to finance long-term care services and supports for more than 12 million Americans, leading a Congressional committee to push toward a possible legislative...