The CMS terminated an Ohio hospital's Medicare and Medicaid funding because it didn't serve enough patients. The hospital hopes the agency will delay the decision.
The CMS announced a new model to give Part D plans more skin in the game to cut Medicare's drug spending, and it will expand the scope of its Medicare Advantage value-based design model.
Medicare Payment Advisory Commission members say the panel needs to explore how to lower hospitals' drug prices covered under Medicare Part A, with some members floating binding arbitration as a possibility.
Previous cuts to the DSH program brought NYC Health & Hospitals to the brink of being unable to pay its workforce on time in fall 2017. Now, it wants to change the state formula altogether.
The Medicare Payment Advisory Commission decided to recommend Congress approve a 2% payment hike for long-term care hospitals because there were concerns over whether the current payment rates are adequate.
The Medicare Payment Advisory Commission recommended that Congress pass legislation to consolidate most of Medicare's value-based quality programs and boost payments for high-performing hospitals.
Medicare Advantage insurers added 1.4 million members to their rosters for 2019, as they looked to grow membership in a market known for being politically safe and predictably lucrative. But membership is growing at slower pace than in previous years.
Two Supreme Court justices questioned the federal government's assertion that its Medicare DSH formula change didn't amount to substantive policy. The change affects billions of dollars in reimbursement payments.
HHS and hospitals will argue before the U.S. Supreme Court this week over whether HHS violated the law when it recalculated the Medicare DSH payment formula without seeking public comment.
Considering the pressure the CMS has faced over the past year to address concerns that accrediting agencies face conflicts of interest, some industry observers think the agency could make meaningful changes to how accreditors operate.
In the wake of the Blue Wave, progressive Democratic legislators are making headway in airing a single-payer policy proposal before key House committees.
Medicare Next Generation accountable care organizations produced $129 million in savings for the CMS in 2017 while earning an average of $3.3 million each in bonuses for beating cost targets and meeting quality benchmarks.