Primary Care Docs Face Medicare Pay Cuts
Primary care physicians will see their Medicare reimbursement decline next year when a program that pays them a 10 percent bonus expires. The program, launched in 2011 to help close the gap between private insurance and Medicare primary care payments, [...]
Medicare’s Bundled Payments Challenge
Now that the U.S. Department of Health and Human Services has set a target of making 50 percent of all Medicare payments through alternative payment systems by the end of 2018, one of those alternative systems, known as “bundled payments,” [...]
Push From Volume to Value Continues
As the end of 2015 nears, CMS has used its blog to reflect on its continued efforts to move the U.S. health care system from one that pays for the volume of care provided to one that pays for the [...]
Feds Seek to Regulate Narrow Networks
Amid concerns that low-cost health plans are reducing their provider networks to contain costs at the expense of access to care for their members, the Centers for Medicare & Medicaid Services (CMS) is proposing new guidelines to limit how much [...]
OIG Reveals 2016 Plans
The U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) has published its work plan for the 2016 fiscal year. In 2016, the OIG will continue to examine all aspects of HHS endeavor, including Medicare, Medicaid, [...]
Feds OK Medicaid Money for Housing
The Obama administration has informed state Medicaid programs that they may use federal Medicaid money to help the chronically homeless obtain housing. While a June bulletin to state Medicaid directors technically only clarified existing policy, it signaled states that the [...]
Study Looks at Social Determinants of Health
A new issue brief from the Kaiser Family Foundation looks at the social determinants of health and health outcomes. The issue brief “Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity” reports that Social determinants [...]
Study: Medicaid Denying Expensive Hepatitis C Drugs
A new study has found that state Medicaid programs are rejecting nearly 50 percent of requests to administer expensive hepatitis C drugs to patients. According to a review of prescription data for Delaware, Maryland, New Jersey, and Pennsylvania, 46 percent [...]
House Committee Forms New Medicaid Task Force
The House Energy & Commerce Committee has created a new task force “to strengthen and sustain the critical program for the nation’s most vulnerable citizens.” According to a committee news release, the task force “…will examine the program to determine [...]
CMS Requires States to Monitor Medicaid Access
A new federal regulation requires states to monitor access to Medicaid services. According to a new regulation issued by the Centers for Medicare & Medicaid Services (CMS), states must submit to CMS plans for monitoring Medicaid beneficiary access to care [...]
