CMS said it is poised to claw back $1 billion from Medicare Advantage organizations by 2020 through widespread audits, according to a proposed rule. 1. The rule, set to hit the federal register Nov. 1 ...

On January 16, the Centers for Medicare & Medicaid Services (CMS) & the U.S. Department of Health and Human Services (HHS) withdrew an appeal to a recent copay accumulator court decision, HIV and ...

CMS will pay for certain angioplasty and stenting procedures in ASCs beginning Jan. 1, under its 2020 Medicare Hospital Outpatient Prospective Payment System and ASC Payment System Final Rule. 1. ASCs ...

In just more than a decade, the number of complaint surveys CMS has investigated in hospitals has gone from 1,294 in 2008 to 3,491 complaint surveys in 2019. Missed deficiencies within the physical ...

Insurers gave out approximately $2 billion in rebates for 2020 to nearly 10 million consumers under the Affordable Care Act’s (ACA's) medical loss ratio provision. The Centers for Medicare & Medicaid ...

New government data puts in stark relief how dramatically telehealth use exploded last year, with the share of Medicare visits conducted virtually skyrocketing from just 840,000 in 2019 to 52.7 ...

WASHINGTON, July 17-- Jeanine Levinson, director of budget and reimbursement at Sturdy Memorial Hospital, Attleboro, Massachusetts, has issued a public comment on the Centers for Medicare and Medicaid ...

This article examines how CMS’ adjustment for social risk factors affects the Medicare Advantage Star Ratings and the type of contracts affected by the adjustment. Objectives: CMS implemented the ...

SOURCE Authors’ analysis of Medicare fee-for-service claims. NOTES The period before the waiver was January 1, 2019–March 5, 2020. The period after the waiver took effect was March 7, 2020–March 31, ...

More than 41.5 million people have been impacted by or received care in CMS innovation center models in the past two years, according to a new estimate from the agency. That includes Medicare and ...