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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

Arkansas DHS reveals breach of client personal information

The Arkansas Department of Human Services says personal and health information of more than 26,000 Medicaid recipients has been breached. DHS said Friday that the information includes Social Security numbers … Click to Continue »

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 […]

More than 100 NY groups urge Congress to reject budget cuts

A coalition of more than 100 nonprofit community service organizations is urging New York's congressional delegation to reject proposed budget cuts to food stamps, Medicaid and other social programs. The … Click to Continue »

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 […]

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

2 weeks 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 […]

Florida provides sickening blueprint for what Republicans want to do to sick kids on Medicaid

CNN just published an in-depth, horrifying investigative story on the state of Florida's 2014-15 to systematically remove sick and disabled children from "a highly respected program called Children's Medical Services, or CMS, a part of Florida Medicaid" and onto private plans with companies who happen to be big donors to the state Republican party. Show More Summary

Medicare Unveils ‘Skeletal’ Site For Hospice Comparison Shopping

last monthHealth : The Checkup

Medicare launched a website aimed at helping families choose a hospice — but experts say it doesn’t help very much. The Centers for Medicare & Medicaid Services this week released Hospice Compare, a c...

6 insurers to take part in overhauled Medicaid managed care

The state of Illinois has cut in half the number of insurers in its Medicaid managed care program. The Illinois Department of Healthcare and Family Services announced Friday it has … Click to Continue »

Woman accused of overbilling Medicaid for services

Authorities say a woman who provided house care and other aid for an ailing man overbilled Medicaid for services she never provided. The Lincoln Journal Star reports that 55-year-old Debra … Click to Continue »

Blue Cross Blue Shield picks federal agency executive as CEO

North Carolina's biggest health insurer has picked a top executive with the federal Centers for Medicare and Medicaid Services to become its next CEO. Blue Cross and Blue Shield of … Click to Continue »

Desperate last-ditch attempt to save the right to sue abusive nursing homes

last monthHumor / odd : Boing Boing

In 2016, the Centers for Medicare and Medicaid Services barred nursing homes from forcing their residents into accepting binding arbitration agreements, insisting that nursing homes that engaged in neglect, physical or sexual abuse should...Show More Summary

Low Medicaid rates limit beneficiaries' access to assisted living facilities

(RTI International) A new study by RTI International found that low Medicaid payment rates for services in assisted living and similar settings discourage residential care providers from serving Medicaid beneficiaries, which limits their access to community-based residential care.

Low Medicaid Rates Limit Beneficiaries' Access to Assisted Living Facilities, Quality Care

A new study by RTI International found that low Medicaid payment rates for services in assisted living and similar settings discourage residential care providers from serving Medicaid beneficiaries, which limits their access to community-based residential care.

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