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Medicaid Will Always Trample Someone's Values

Last week, the federal Centers for Medicare & Medicaid Services (CMS) issued a “guidance letter” that makes it easier for states to exclude abortion providers (chiefly Planned Parenthood) from Medicaid. According to the National Right...Show More Summary

New Part D Data: CVS Wins Big in 2018's Preferred Pharmacy Networks

Just-released data from the Centers for Medicare & Medicaid Services (CMS) confirms that preferred cost sharing networks will continue to dominate Medicare Part D. Our exclusive analysis finds that for 2018, 99.9% of seniors are enrolled...Show More Summary

109 Healthcare Groups Urge Congress to Immediately Reverse CMS Policy Linking Physician Payment Adjustments to Part B Drug Costs

More than 100 of the nation's leading patient and provider organizations - including the American College of Rheumatology - are urging Congressional leaders to immediately reverse a new Centers for Medicare & Medicaid Services (CMS) policy that will create enormous financial uncertainty for specialty providers and jeopardize patient access to vital Part B drug therapies.

Medicaid work requirements and the Kentucky 1115

Yesterday, the Center for Medicare and Medicaid Services (CMS) released a guidance letter to state Medicaid directors saying that CMS would welcome Section 1115 Waiver applications that contained work requirements.  The guidance would not provide any extra money for supportive employment or services and it’s logic chain of justifying employment as a condition of receiving […]

The Trump administration will now allow states to require people on Medicaid to have a job

The Centers for Medicare and Medicaid Services released guidelines Wednesday allowing states to implement work requirements for Medicaid. While Medicaid enrollees would have to prove they were employed, in school, or in a job training...Show More Summary

CMS to cover Abbott's glucose monitoring device

2 weeks agoHealth : Reuters: Health

(Reuters) - Abbott Laboratories said on Thursday its newly launched glucose monitoring device would be covered by the Centers for Medicare & Medicaid Services, expanding its usage to millions of diabetes patients in the United State...

Changes in Healthcare Costs

I had a post the other day trying to make sense of changes in healthcare costs. Based on some of the comments to that post, a bit more thought, some data from the Centers for Medicare and Medicaid Services, and the CPI-All Urban Consumers, I think my point distills down to this graph: (click to embiggen) Anyway, […]

Medicare repeatedly penalizes Maine hospital

A Maine hospital is being penalized for the second year in a row for high rates of infection and patient injuries. The Sun Journal reports the Centers for Medicare & … Click to Continue »

Feel-Good Stories About Medicare CGM Coverage

Although those of us on Medicare are thankful that Centers for Medicare & Medicaid Services (CMS) now covers the Dexcom G5 continuous glucose monitor (CGM), many online discussions are angry and focused on the frustrating regulation that we are not allowed to use our smartphones, smart watches, and pumps as receivers. I wrote a blogpost about […]

Rush Hospitals Receive Five Stars for Quality of Care

Rush University Medical Center and Rush Copley Medical Center each have received five stars, the highest possible rating, for hospital quality from the federal Centers for Medicare and Medicaid Services. CMS, as the centers are known, published the latest overall ratings for hospitals nationwide on their Hospital Compare website today.

Maryland gets OK to expand developmentally disabled service

Maryland has received federal approval to expand services for people with developmental disabilities. The state health department said Thursday said the Centers for Medicare and Medicaid Services approved expanding services … Click to Continue »

CMS Confirms It: Drug Spending Slows, Hospital and Physician Spending Grows

Last week, the econowonks at the Centers for Medicare & Medicaid Services (CMS) released the 2016 National Health Expenditure (NHE) data. Links below. It’s politically fashionable to blame healthcare spending growth on pharmaceuticals, but it’s also inaccurate. Show More Summary

New York’s BHP problem

Tim Jost at Health Affairs picks up on an important letter that the Center for Medicare and Medicaid Services (CMS) sent to New York. New York runs a Basic Health Plan. A BHP allows a state to take 95% of the funding for advanced premium tax credits (APTC) and cost sharing reduction (CSR) subsidies to […]

Yelp reviewers take a dimmer view of nursing homes than federal Nursing Home Compare

Yelp reviewers give nursing homes significantly less favorable ratings than those found on the federal website, Nursing Home Compare, run by the Centers for Medicare and Medicaid Services, new research has found.

Foundation's cancer gene test gets U.S. FDA and Medicare nod

2 months agoHealth : Reuters: Health

CHICAGO (Reuters) - A test from Foundation Medicine Inc that can detect cancer-causing mutations in 324 genes has won approval from the U.S. Food and Drug Administration and the Center for Medicare and Medicaid Services, the agencies said.

CMS Officially Cancels Mandatory Bundle Payment Models 

Today, the Centers for Medicare & Medicaid Services (CMS) has announced the cancellation of the mandatory hip fracture and cardiac bundled payment models that were to be operated by the CMS Innovation Center and implemented changes to the Comprehensive Care for Joint Replacement (CJR) Model. These changes will offer greater flexibility and choice for hospitals... Read More

VBID in Medicare Advantage

The Center for Medicare and Medicaid Services (CMS) announced late last week that they are expanding their Medicare Advantage Value Based Insurance Design (VBID) project (from Modern Healthcare) Insurers in 25 states will be able to apply for the Medicare Advantage Value-Based Insurance Design Model in 2019, the CMS announced Wednesday. The program is available […]

Southwestern Health Resources ACN Ranked No. 7 with Millions Saved, Quality Measures Above 95%

The Southwestern Health Resources Accountable Care Network (ACN) has saved the Centers for Medicare & Medicaid Services (CMS) more than $73 million over the past three years, including nearly $37.3 million in 2016, while maintaining a Quality Score over 95 percent, according to the latest figures. The savings rank the Southwestern Health Resources ACN No. 7 in the nation.

Will CMS Pop the Gross-to-Net Bubble in Medicare Part D With Point-of-Sale Rebates?

Last week, the Centers for Medicare & Medicaid Services (CMS) released its 713-page proposed policy changes and updates for the Medicare program. See the links below. Buried in this document is a radical concept: Part D plans would be required to recognize the value of manufacturer rebates and pharmacy payments in retail prescription prices. Show More Summary

American College of Rheumatology responds to CMS Innovation Center request for information

(American College of Rheumatology) The American College of Rheumatology (ACR) urged the Centers for Medicare and Medicaid Services (CMS) to remove barriers that make it difficult for subspecialists and providers in small practices to...Show More Summary

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