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Medicare

April 05, 2021 | Daily News

Medicare Payment Advisory Commission members signaled they will start looking into transparency and accountability of health care ownership during an informational session on private equity in health care Friday (April 2), saying these issues are not solely driven by private equity ownership in the health sector and can affect Medicare costs.

April 02, 2021 | Daily News

Medicare payment advisors unanimously agreed to direct HHS to put together a smaller and more harmonized group of alternative payment models as a first step to improving those demonstrations and Chair Michael Chernew said the commission will continue looking at how to improve value-based care when it reconvenes in the fall.

April 02, 2021 | Daily News

Medicare Payment Advisory Commission staff estimate CMS’ policy of basing Medicare laboratory pay rates on commercial-payer rates will save 24% on average once it is fully implemented, but they say the savings will vary based on the test type and warn independent labs’ overrepresentation in the data collection might skew rates to the lower end and affect patient access.

April 02, 2021 | Daily News

The Medicare Payment Advisory Commission voted to recommend Congress create a new value incentive program to reward skilled nursing facilities for good performance at its meeting Thursday (April 1).

April 02, 2021 | Daily News

Medicare payment advisors voted Thursday (April 1) to recommend Congress replace Medicare Advantage’s benchmark policy with a new system that would share plans’ MA cost efficiencies with the federal government.

April 01, 2021 | Daily News

LeadingAge on Thursday (April 1) released a wishlist for Congress’ upcoming infrastructure package that includes a permanent 10% increase in the federal Medicaid matching funds for both home- and community-based and nursing home services.

April 01, 2021 | Daily News

The American Hospital Association says the backlog of Medicare appeals is down 69% from when a federal court first directed HHS to fix the problem.

March 31, 2021 | Daily News

CMS pushed back its request for Accountable Care Organizations to submit applications to the Community Health Access and Rural Transformation (CHART) Model by a year, until spring 2022, to the disappointment of the ACOs.

March 31, 2021 | Daily News

Medicare Advantage beneficiaries spent an average of $1,640 less on out-of-pocket and premium costs than traditional Medicare beneficiaries in 2018, according to a new study released by pro-MA coalition Better Medicare Alliance Tuesday (March 30).

March 30, 2021 | Daily News

CMS will hold Medicare claims “for a short period” after April 1 so that providers don’t see the 2% Medicare sequestration cuts go into effect before lawmakers take final action to extend the moratorium on those cuts.

March 30, 2021 | Daily News

Only about 40% of hospitals that applied to be exempt from certain site-neutral provisions for off-campus departments were granted that exemption, but the American Hospital Association says CMS was too slow in conducting audits to affirm the requests so it should either reverse the denials to the remaining 60% or allow hospitals that were denied exceptions to appeal.

March 25, 2021 | Daily News

Longtime Democratic operative Chris Jennings has joined the governance board of the Institute for Clinical and Economic Review, an independent organization that assesses drug values and that could become a key part of Democrats’ plan to control drug prices.

March 25, 2021 | Daily News

As providers and lobbyists anticipated, the Senate on Thursday (March 25) passed an extension of the Medicare sequester moratorium through the end of the year, but the legislation doesn’t include a House provision that would also head off additional sequester cuts created by the American Rescue Plan.

March 25, 2021 | Daily News

A bipartisan group of representatives introduced a bill Wednesday (March 24) that would allow Medicare Advantage plans to count diagnoses from audio-only telehealth services towards risk adjustment for at least plan years 2020 and 2021 and allow providers to be reimbursed at the same rate for audio-only telehealth and in-person care during the public health emergency.

March 24, 2021 | Daily News

Sen. Amy Klobuchar (D-MN) on Monday (March 22) reintroduced legislation to let Medicare negotiate drug prices, and the bill has 32 Democratic senator cosponsors, including Sen. Joe Manchin (D-WV), who has frustrated Democrats on other policies.

March 24, 2021 | Daily News

Advocates are pushing to advance health equity for people with intellectual and developmental disabilities through policies like COVID-19 vaccine prioritization, increased access to home- and community-based services and better coverage and delivery of care.

March 23, 2021 | Daily News

The American Hospital Association is hoping the Senate will pass an extension of the Medicare sequester moratorium in the next few days and CMS will take that as a signal to hold off on any provider pay cuts until after the House passes the Senate version of the legislation.

March 23, 2021 | Daily News

American Medical Association CEO and Executive Vice President James Madara said he thinks price transparency is coming to the entire health care system, including private-practice physicians, during a panel at the American College of Healthcare Executive’s conference on Monday (March 22).

March 22, 2021 | Daily News

Members of the American Medical Rehabilitation Providers Association urged lawmakers to extend the timeline of the IMPACT Act, change prior authorization requirements and withdraw CMS’ review choice demonstration for inpatient rehabilitation hospitals during an advocacy conference last Wednesday (March 17).

March 19, 2021 | Daily News

The House on Friday (March 19) passed 246-175 legislation to extend the Medicare sequester moratorium through the end of the year and keep the cost of the American Rescue Plan from leading to further cuts, but the bill faces an uphill battle in the Senate and some Medicare experts question the fiscal wisdom of continuing to put off the 2% sequester cut that has been on hold during the pandemic.

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