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News
Healthcare industry doesn't want unique plan identifiers: WEDI
By Joseph Conn | September 29, 2014 | Basic Web Basic Web Subscription Details
When Congress passed the Health Insurance Portability and Accountability Act in 1996, it saw “administrative simplification” as a general benefit and specifically called for the adoption of several national numerical identifiers as a way to boost efficiency, reduce waste and control...
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News
Medicare's Pioneer program down to 19 ACOs after three more exit
By Melanie Evans | September 25, 2014 | Basic Web Basic Web Subscription Details
Three more accountable care organizations dropped out of Medicare's Pioneer program, which was designed to test the payment and delivery model with a small group of elite providers deemed best prepared to handle the operational demands and financial risks.
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News
CMS seeks to clarify coverage for autism treatment under CHIP, Medicaid
By Virgil Dickson | September 25, 2014 | Basic Web Basic Web Subscription Details
The CMS has moved to clarify confusion about a bulletin it released in July on coverage for comprehensive autism treatment under Medicaid and the Children's Health Insurance Program. Uncertainty centered on whether the CMS was mandating coverage for applied-behavior analysis therapy, a costly...
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News
Fewer Medicare Rx plans offered for 2015: Avalere study
By Paul Demko | September 22, 2014 | Basic Web Basic Web Subscription Details
The number of prescription drug plans available to seniors will drop by roughly 14% for 2015, according to an analysis of Medicare filings by Avalere Health. The number of Medicare Part D plans nationwide will decrease from 1,169 this year to 1,001 in 2015.
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News
CMS targets nursing homes' overuse of antipsychotic drugs
By Sabriya Rice | September 22, 2014 | Basic Web Basic Web Subscription Details
The CMS will push nursing homes to reduce their use of antipsychotic medications by 25% by the end of 2015 and plans to incorporate a measure of the drugs' use to its star-rating system for consumers.
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Information
Kentucky aiming to revamp services for elderly
By Associated Press | September 21, 2014
Kentucky is overhauling its elderly services with the aim of stretching resources and helping aging baby boomers remain independent and live out their final years at home, rather than in an institution.
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Vital Signs
Why one congressman wants to scrap Medicare's hospital appeals deal
By Bob Herman | September 19, 2014
The CMS has been pretty quiet about its Medicare appeals settlement for hospitals, and now a congressman wants the agency to retract the offer altogether.
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News
Many new Medicaid enrollees in the dark about benefits, MACPAC hears
By Virgil Dickson | September 19, 2014 | Basic Web Basic Web Subscription Details
Newly enrolled Medicaid beneficiaries are receiving little to no guidance from states or managed-care plans regarding the scope of services they're eligible to receive, according to focus group findings prepared for Medicaid and CHIP Payment and Access Commission.
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News
With Kaiser in sight, Anthem creates new plan with major California hospitals
By Bob Herman | September 17, 2014 | Basic Web Basic Web Subscription Details
Health insurer Anthem Blue Cross and seven competing health systems in Southern California are joining forces to create a new health plan that executives believe will enhance competition in the area while reducing healthcare costs.
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News
Medicare ACOs improve quality, have mixed results on slowing spending, CMS says
By Melanie Evans | September 16, 2014 | Basic Web Basic Web Subscription Details
The participants in Medicare's programs for accountable care organizations have continued to produce mixed results. Quality broadly improved but savings proved more elusive among the early participants.
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