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EXCLUSIVE: Preferred Pharmacy Networks Will Dominate 2018 Medicare Part D Plans (Plus: We Review the Top Plan Sponsors)

The Centers for Medicare & Medicaid Services (CMS) has just released the initial raw data on the 2018 Medicare Part D plans. Our exclusive analysis of these data reveals that preferred cost sharing pharmacy networks have officially won. Show More Summary

Kansas wins approval to continue private Medicaid system

The federal government has given Kansas permission to operate its private Medicaid system for another year. State officials announced Monday afternoon that the Centers for Medicare and Medicaid Services has … Click to Continue »

West Virginia gets OK to expand Medicaid drug treatment

State health officials say they have received federal approval to expand addiction treatment for West Virginians covered by Medicaid. The waiver from the U.S. Centers for Medicare and Medicaid Services … Click to Continue »

The Three Things Keeping Hospital CEOs Up Late at Night (Hint: Donald Trump Isn’t One of Them)

By PAUL KECKLEY The Center for Medicare and Medicaid Innovation released a Request for Information (RFI) last week– “New Direction for the CMS Innovation Center.” It’s the latest chapter in the unfolding policy framework that will govern the health system for at least the next 3 years. The RFI, which doubles down on value-based alternative

Trump directed HHS to deny Iowa’s proposal to fix healthcare

2 weeks agoNews : NY Daily News

Trump directed Seema Varma, the head of the Centers for Medicare and Medicaid to deny Iowa's Stopgap Measure.

5 Common Medicare Myths, Debunked

There is no larger health insurance program in the United States than Medicare. According to the Centers for Medicare & Medicaid Services, more than 57 million people were receiving health benefits through the program as of March 2017. But just because millions are on Medicare doesn't mean...

Rheumatology leaders applaud CMS for withdrawing Medicare Part B payment demonstration

(American College of Rheumatology) The American College of Rheumatology commends the Centers for Medicare and Medicaid Services (CMS) for finalizing its decision to withdraw the Part B Drug Payment Demonstration.

CMS Unveils “New Direction” for Innovation Center to Promote Patient-Centered Care

The Centers for Medicare & Medicaid Services (CMS) has unveiled a “new direction for the Innovation Center” to promote patient-centered care and test market-driven reforms. The goal of this new direction for the CMS Innovation Center...Show More Summary

Federal government continues to review Iowa's ACA plan

The federal government continues to review Iowa's short-term funding proposal to redirect Affordable Care Act money to lower some people's health insurance costs. A representative for the Centers for Medicare … Click to Continue »

Remicade: A Case Study in How U.S. Pricing and Reimbursement Curb Adoption of Biosimilars

The Centers for Medicare & Medicaid Services (CMS) has just released the Average Sales Prices (ASP) reimbursement data for the fourth quarter of 2017. You can download the drug pricing files here. Below, I use these data to explore the reimbursement and payer dynamics behind the relatively slow adoption of Inflectra, the first biosimilar of Remicade. Show More Summary

Telehealth and Online Platforms Should not be Overlooked as Key Tools in 2018 Expansion of Medicare Diabetes Prevention Program (MDPP)

The American Association of Diabetes Educators (AADE) filed public comments recently on a proposal by the Centers for Medicare & Medicaid Services (CMS) to provide education on how to prevent or delay the onset of type 2 diabetes via the Medicare Diabetes Prevention Program (MDPP). Show More Summary

ACP submits recommendations on 2018 Physician Fee Schedule proposal

(American College of Physicians) ACP today provided more than a dozen recommendations on the proposed rule for the calendar year 2018 Medicare Physician Fee Schedule to the Centers for Medicare and Medicaid Services (CMS). ACP's recommendations...Show More Summary

Am I the first user of the CMS’ Hospice Compare website?

In a terrible twist of fate, the very day that the Centers for Medicare & Medicaid Services (CMS) Hospice Compare website went live, I found myself in a pulmonologist’s office with my parents, taking in the news of my mother’s advanced cancer and malignant pleural effusion. The shock of it, and the uncanny timing are […]

President Trump Cuts 90% of Taxpayer-Funded Advertising for Failed Obamacare Program

The Centers for Medicare and Medicaid Services announced Thursday that they will spend $10 million on advertising for the upcoming November Obamacare enrollment period. This is 90 percent less than the $100 million the Obama administration spent on advertising enrollment last year. “A healthcare system that has caused premiums to double and left nearly half […]

Trump Begins ObamaCare Sabotage

Arguing that the promotional spending was ineffective, the Health and Human Services department will cut the sign-up advertising budget to $10 million for 2018 coverage from $100 million for this year, the Centers for Medicare and Medicaid Services said in a statement. Show More Summary

Advertising budget for Obamacare to be cut 90 percent: U.S. health agency

2 months agoHealth : Reuters: Health

WASHINGTON (Reuters) - The U.S. Centers for Medicare and Medicaid Services said on Thursday it plans to spend $10 million on advertising for the upcoming Obamacare open enrollment period that starts in November, a sharp cut from the $100 million spent last year.

Cheyenne hospital regains Medicare, Medicaid status

Cheyenne Regional Medical Center officials say the hospital has regained its standing with the Centers for Medicare and Medicaid Services after losing its deemed status over a complaint. The hospital … Click to Continue »

AANEM Comments on 2018 MACRA Proposed Rule

The American Association of Neuromuscular & Electrodiagnostic Medicine submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) on August 21 regarding its proposed rule changes on Medicare payment and delivery reform enacted by MACRA (Medicare Access and CHIP Reauthorization Act).

Iowa’s 1332 waiver and CSR populations

Iowa submitted a Section 1332 State Innovation Waiver to the Center for Medicare and Medicaid Services (CMS) yesterday.  It is the biggest and most complex waiver yet to be submitted.  It is an invitation to long and costly lawsuits because of how it uses CSR funding. Other states have submitted reinsurance waivers where they are […]

Compare your own practice patterns to the national average. Here’s how.

In an era of increasing transparency in medicine, the Centers for Medicare & Medicaid Services (CMS) has been publishing data annually on payments to individual physicians since 2014. The database, officially called the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File, has been a window (albeit a cracked and opaque […]

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