Tag Archives: CMS

With Health Care At Pivotal Crossroads, HHS Pick Could Signal What Path Trump Wants To Take

President Trump’s selection of a secretary of health and human services could be a turning point in a health care debate that has polarized Washington, as he faces a choice of working with Democrats to fix the current system or continuing his so-far faile Continue reading

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With Price out at HHS, talk turns to replacement candidates

By most accounts, the leading candidate is Seema Verma. Some of her actions at the CMS have alarmed the healthcare industry, including the decision to eliminate and scale back some mandatory bundled payment programs and her plan to seek a “new direction” Continue reading

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Heart Device Failure: Medicare Spent $1.5B Over 10 Years To Replace Defective Implants

Medicare paid at least $1.5 billion over a decade to replace seven types of defective heart devices, a government watchdog says. The devices apparently failed for thousands of senior patients. Continue reading

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Medicare Bundled Payments for Orthopedic and Cardiac Care to Proceed, HHS Says

A final rule by the Department of Health and Human Services (HHS) that establishes several cardiac and orthopedic bundled-payment models under Medicare was recently delayed; however, recent reports clarified that the launch date of the bundled-payment mod Continue reading

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Reminder: BFCC-QIOs have Resumed Two-Midnight Reviews

Given the resumption of BFCC-QIO short-stay reviews, providers should be prepared for BFCC-QIO review of claims that fall within the six-month look back period and were not formally denied. Continue reading

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Two Midnight rule helped slash improper payments for inpatient hospital claims by 58 percent, CMS says

said the overall Medicare fee-for-service improper payment rate dropped from 12.1 percent in 2015 to 11.0 percent in 2016. Moreover, improper payments for inpatient hospital claims alone dipped by 58.3 percent, from 9.2 percent in 2014 to 3.8 percent in 2 Continue reading

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Medicare outpatients risk higher bills for some procedures

You pay less for outpatient treatment than for a hospital admission, right? Not necessarily in the topsy-turvy world of Medicare billing, according to a government report. Continue reading

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Proposed Mandatory Medicare Cardiac Bundles:  The Pushback Begins

CMS’s October 3 deadline for comments on the proposed mandatory Medicare cardiac bundle was greeted with hundreds of comments – many of a highly technical nature that will get worked out (or ignored) in the final regulations. Continue reading

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MedPAC discusses draft 2018 payment recommendations for post-acute care

The Medicare Payment Advisory Commission this week discussed draft recommendations that would forgo increases in or reduce Medicare payment rates in 2018 for home health agencies, skilled nursing facilities, inpatient rehabilitation facilities and long-te Continue reading

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Slavitt Offers Value-Based Care Steps Post MACRA Implementation

As CMS gets ready for MACRA implementation in the new year, CMS Acting Administrator Andy Slavitt urged healthcare and political leaders to carry on value-based care progress made under the Affordable Care Act. Continue reading

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