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Comments on Meaningful Use Rule Pushing for Modifications and Delay

Written by Joseph Conn // December 16, 2015 // Modern Healthcare The federal government’s $31.7 billion electronic health-record incentive payment program needs to be refocused on promoting...

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Over Half of ACA Co-Ops Are Off the Market

Amy Goldstein // November 3, 2015 //  The Washington Post More than half of the nonprofit health insurance co-ops formed through the Affordable Care Act are now off the market for the coming year, with...

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The CMS Proposed Rule to Allow Sharing of Medical Claims Data

Written by Joseph Conn and Sabriya Rice // January 29, 2016 // Modern Healthcare (Story updated at 12:30 p.m. Eastern) Some medical data miners may soon be allowed to share and sell Medicare and...

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CMS Issuing Reinsurance Payments for 2015 Enrollment

Written by Susan Morse // February 15, 2016 // Healthcare Finance Health insurers who sold plans through the marketplaces in 2015, and who covered high cost individuals can expect to get $7.7 billion...

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CMS and AHIP Announce Agreement for Quality Measures

Written by Melanie Evans // February 16, 2016 // Modern Healthcare (This story was updated at 4 p.m. Eastern.) The Obama administration and health insurers took a step Tuesday toward standardizing and...

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The CMS Releases Final ACA Rules for 2017

Written by Ayla Ellison / Becker’s Hospital Review / March 1, 2016 CMS has released a final rule containing standards for health insurers selling coverage through the Affordable Care Act exchanges in...

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Affordable Care Act Receives Suspension on Insurance Taxes

Written by Bob Herman / March 1, 2016 / Modern Healthcare Congress’ decision to suspend the Affordable Care Act’s tax on health insurers for one year will cost the government $13.9 billion, funding...

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The CMS is Enhancing Provider Enrollment Screening

February 24, 2016 // Healthcare Billing & Management Association In a February 22nd blog post, the Centers for Medicare and Medicaid Services (CMS) announced that it will implement new strategies...

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The CMS is Searching for a Company to Develop a Star Rating Plan for Dual...

The CMS has announced that they are searching for a company to contract to create star rating plan measures for health plans that are for enrollees that are eligible for both Medicare and Medicaid....

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Medicare Proposes New Part B Drug Payment Model

According to a proposal released Tuesday by the Centers for Medicare & Medicaid Services, Medicare is proposing a new payment model for Medicare’s Part B program for prescription medications within...

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CMS Announces Lower 2017 Medicare Advantage Payments

On Monday, the Centers for Medicare and Medicare Services (CMS) announced that the average payments for 2017 Medicare Advantage plans will be lowered to 0.85%. Medicare Advantage plans are paid based...

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The CMS Announces New Initiative for Primary Care

The CMS announced The Comprehensive Primary Care Plus initiative on Monday that plans to transform the delivery and reimbursement for primary care in the United States. In the initiative, the CMS will...

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CMS Postpones Star Quality Ratings

The Centers for Medicare and Medicaid Services (CMS) announced earlier this year that there will be a new release of star quality ratings for hospitals in the United States in an effort to assist...

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The CMS Finalized An 85% Medical-Loss Ratio for Managed Medicaid

The Centers for Medicare and Medicaid Services (CMS) has announced a final ruling for the federal medical-loss ratio (MLR), setting it at 85%. The ruling states that 85% of insurer’s Medicaid revenue...

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Quality Payment Program Announced by CMS for Physician Payment

The Centers for Medicare and Medicaid Services (CMS) announced Wednesday a new quality payment plan called the Quality Payment Program, which is proposed to guide how the Medicare Access and CHIP...

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Healthcare Providers Competing to Attract Doctors, as the Number of Primary...

The number of primary care physicians in the nation is continuing to decrease, an issue that federally qualified health centers have typically faced, but has now become a greater burden. According to a...

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Healthcare Spending Rises to $3.2 Trillion in 2015

In 2015, healthcare spending in the U.S. rose to $3.2 trillion, which is a 5.5% increase in spending from 2014. Economists estimate that the national health spending rate will increase by an average of...

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MACRA – What You Need to Know

MACRA, the Medicare Access and CHIP Reauthorization Act of 2015, is slated to be in effect as soon as January 1, and it’s final rules are set to be released in November. MACRA changes the way in which...

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CMS Announces Hospital Star Ratings

The Center for Medicare and Medicaid Services released the Overall Hospital Quality Star Ratings that will be used to rate hospitals in the nation on the quality of the facility and services. The...

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Aetna Pulls Out of ACA Markets in 11 States

Aetna announced on Monday that it will be reducing their participation in the Affordable Care Act, affecting 11 states. The health insurance giant’s move was due to a block by the DOJ of Aetna’s...

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