Accountable care models will be almost universal for Medicare and Medicaid beneficiaries by 2030, CMS leaders say
A forthcoming revamp of federal value-based payment models will include features designed to encourage provider participation, CMS and CMMI leaders said.
Hospital groups express concern over earlier court ruling that could expand False Claims Act liability
The groups argue that allowing FCA claims to be brought for post-termination actions would defy congressional intent and leave hospitals subject to excessive financial liability.
With substantial Medicare payment cuts pending, medical groups call for Congress to act
Payment cuts scheduled for 2022 would amount to a 9.75% reduction in Medicare revenue for medical groups, which are calling on Congress to pass legislation to stop the cuts.
The stakes are only growing in efforts to improve the cost effectiveness of health, CMMI’s Elizabeth Fowler says
The head of the Center for Medicare & Medicaid Innovation spoke with an HFMA audience about the importance of efforts at the federal level and beyond to improve the cost effectiveness of health.
After a long wait, HHS sends out details on the next Provider Relief Fund distributions
The U.S. Department of Health and Human Services announced $25.5 billion in upcoming distributions from the Provider Relief Fund.
Site-of-care payment issues get highlighted by UnitedHealthcare and MedPAC
A new report issued by a leading health plan is the latest sign that hospitals and health systems can expect payers to ramp up implementation of site-neutral payments.
Why responding to site-neutral payment risk is imperative for hospitals and health systems
As the likelihood of site-neutral payments increases over a range of services, hospitals and health systems must understand which services are most at risk from these changes and determine how quickly they will respond.
Recipients of COVID-19 vaccine boosters won’t have to pay anything out of pocket, CMS confirms
Medicare beneficiaries will owe nothing out of pocket for receiving an authorized booster dose, and the same applies to almost all Medicaid beneficiaries and most commercial health plan members.
AMA releases 2022 CPT code set with new options that apply to COVID-19 vaccination, digital care services and more
The new set features more than 400 CPT code changes from 2021.
COVID-19 vaccination of staff now a condition of participation in Medicare and Medicaid, CMS announces
In a major expansion of COVID-19 vaccine requirements, the Biden administration announced Sept. 9 that all staff working at Medicare- and Medicaid-certified facilities must receive the vaccine.