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Why Medicare's List Of Costly Drugs Is Kind Of Bogus

No, the most expensive drug for the U.S. Medicare drug benefit program is not Nexium, the heartburn medicine – no matter what Medicare says. According to data released by the Centers for Medicare & Medicaid Services last night – and put in a front-page story by the Wall Street Journal -- [...]

Medicare Part D Should be Allowed to Obtain More Rebates for Drugs: Study

A new report is encouraging the Centers for Medicare & Medicaid Services and Congress to pursue additional rebates for prescription drugs purchased for the Medicare Part D program.

Back to Basics

The Basic Plan is part of the Affordable Care Act.  States can request permission from the Center for Medicare and Medicaid Services (CMS) to set up a health plan for people whose incomes are between 138% FPL and 200% FPL.  It is funded by the pooling together of premium tax credit subsidies and cost sharing [Read more...]

CMS Commits $3B to Upgrade Medicaid-Enrollment Systems

The Center for Medicare & Medicaid Services (CMS) is expected to spend $3 billion dollars between fiscal 2016 and fiscal 2025 to help states upgrade and maintain their Medicaid eligibility and enrollment systems, Modern Healthcare first reports. The increase stems from CMS permanently raising the matching rate to 90% from 50% for money that states spend on... Read More

Scott Walker's administration walks back attack on Wisconsin family planning clinics

Gov. Scott Walker (R-WI) Last August, Scott Walker's administration accused two Wisconsin family planning clinics of overbilling Medicaid programs by $3.5 million. Now, the state Department of Health Services has had to walk that back...Show More Summary

$100M IDEAS: CMS Blesses Study to Evaluate Amyloid Scans in Clinical Practice

The Centers for Medicare & Medicaid Services has given the nod to an 18,500-patient study to see whether amyloid scans prove their worth in the clinic. Researchers hope the study will eventually convince CMS and private insurance companies to cover the technology.

The Obama Administration Is Trying to Force Florida into the Medicaid Expansion, So Florida's Suing

The Obama administration, via the Centers for Medicare and Medicaid Services, has threatened to cut off a billion-dollar pool of funds that Florida gets every year from the federal government to pay hospitals to take care of poor patients, called the Low Income Pool, unless Florida agrees to expand Medicaid under Obamacare. Show More Summary

Government paying most doctors full Medicare fees

The federal Centers for Medicare and Medicaid Services had previously said that without action, it would start making payments at the lower rates on Wednesday. In a written statement to health care providers, it says "a small volume of claims" are being processed at the lower levels.

Medicare Announces Coverage for Annual HIV Test

The Centers for Medicare and Medicaid Services (CMS) announced this week that it has expanded coverage to include one, annual voluntary screening for HIV infection for all adolescent and adult Medicare beneficiaries between the ages of 15 and 65, without regard to perceived risk.  Coverage for pregnant Medicare beneficiaries will remain unchanged. The addition of...

Feds to Probe Impact of Generic Drug Price Increases on Medicaid

the Office of the Inspector General of the U.S. Department of Health & Human Services says it will conduct a new review of generic drug price increases on the Medicaid drug rebate program.

The silliest four letters in health care: PQRS

It has become perhaps the silliest four letters in health care: PQRS. It stands for Physician Quality Reporting System. It’s another this and another that created by the Centers for Medicare & Medicaid Services (CMS). After you read this, you’ll be like me, scratching your head trying to understand why anyone thinks our health care system is […]

How to Save Money on Your Prescription Drugs

According to The Centers for Medicaid and Medicare Services, Americans spent over $270 billion on prescription drugs in 2013. The reasons include: • Brand name drug price increases by pharmaceutical manufacturers • Lack of generic equivalents •...Show More Summary

Fifteen days remain before tax filing deadline

CMS continues to raise awareness about the intersection of taxes and health care With the tax filing deadline two weeks away, the Centers for Medicare & Medicaid Services (CMS) is continuing to help consumers understand how health coverage and taxes intersect. This year’s tax season is the first time individuals and families will be asked...

America's Medical Bill Didn't Spike Last Year

There’s more good news about health care spending today—although, as always, it’s hard to know how good the news really is, or for how long it will last.On Wednesday, actuaries at the Centers for Medicare and Medicaid Services (CMS) released th

U.S. top court says private medical providers can't sue states over Medicaid

last monthNews : The Newsroom

By Lawrence Hurley WASHINGTON (Reuters) - The U.S. Supreme Court on Tuesday ruled that private medical providers that deliver residential care services in Idaho cannot sue the state in order to raise Medicaid reimbursement rates to deal with rising medical costs. Show More Summary

NY’s Wage-Parity Scheme Survives Appeal

By Marlene Kennedy, Courthouse News Service Driving up wages in a bid to improve New York's Medicaid workforce does not run afoul of federal law, the 2nd Circuit ruled Friday.

Federal Health Agency Blames Obamacare Launch for Lack of Transparency

last monthNews : Mediaite

The Centers for Medicare and Medicaid Services said Friday it has a bottleneck of Freedom of Information Act requests that may take it more than ten years to sort out. The reason? In part, the agency said, Obamacare.

It’s all tied together

The Incidental Economist’s Austin Frakt is pimping a paper he co-wrote on how Medicaid expansion has lowered demand for Veterans’ Administration health care services: If the ACA’s Medicaid expansion had been implemented in all states, enrollment for VA health coverage, acute inpatient care (days), and outpatient visits would have been 9%, 6%, and 12% lower, [Read more...]

Hospitals fight to charge you more

The Centers for Medicare and Medicaid Services (CMS) has put its foot down, this time on the side of patients. Many hospitals charge you more for the same outpatient tests you get in your doctor’s office. Sixty-six different services are being targeted by CMS to leverage the playing field. Are the tests really all that […]

CMS Innovation Center hard at work?

SEC. 3021 of the Affordable Care Act established the Center for Medicare and Medicaid Innovation (CMI) within CMS. The purpose of the CME is to establish demonstration projects (i.e. tests) of innovative payment and service models that improve the quality, coordination and efficiency of services and reduce expenditures. Show More Summary

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