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Can MedPAC make the two-midnight rule go away?

By Virgil Dickson  |  November 18, 2014

The Medicare Payment Advisory Commission is mulling trying to solve the conundrum posed by the widely panned “two-midnight rule” by eliminating the outpatient observation claims that gave rise to it.

Big-city hospitals more likely to face readmission penalties

By Sabriya Rice  |  November 17, 2014

Hospitals in Chicago, Detroit, New York City, Newark, N.J., and Philadelphia saw the highest average Medicare readmission penalties over the past two reporting periods, according to researchers studying the impact of the program on urban institutions.

Florida home healthcare owner pleads guilty in fraud scheme

By Lisa Schencker  |  November 13, 2014

A former owner of a Miami home healthcare company has admitted that he and others paid kickbacks and bribes to patient recruiters to help them fraudulently bill Medicare $30 million, the U.S. Justice Department announced Thursday.

SGR, CHIP fixes potentially on lame-duck agenda, but prospects look slim

SGR, CHIP fixes potentially on lame-duck agenda, but prospects look slim

By Paul Demko  |  November 12, 2014

The only major task likely to get done during the four-week lame-duck session will be to provide continuing funding for the federal government, which is slated to run out of money Dec. 11. But that isn't stopping healthcare groups from pushing for action.

Pioneer ACOs can recruit seniors under new CMS test

Pioneer ACOs can recruit seniors under new CMS test

By Melanie Evans  |  November 11, 2014

Accountable care organizations have expressed frustration that patients assigned by Medicare have too little allegiance to the doctors and hospitals working to coordinate their care.

CMS says some providers are obstructing dual-eligible demonstration

By Virgil Dickson  |  November 11, 2014

The CMS official in charge of coordinating care for Americans covered by both Medicare and Medicaid says some providers are illegitimately trying to dissuade dual-eligible beneficiaries from participating in a managed-care initiative designed to reduce costs and improve quality.

CMS moves forward with 5-star rating program for dialysis facilities

By Sabriya Rice  |  November 07, 2014

The CMS announced late Friday that it will go ahead in January with the rollout of a 5-star rating system for kidney dialysis providers and will use the same methodology that drew harsh criticism from kidney-care groups this summer.

Medicare pay cut looms despite positive steps in CMS rule, doc groups say

By Andis Robeznieks  |  November 06, 2014

Physicians cheered and jeered parts of a final rule the CMS issued last week that includes Medicare's 2015 physician fee schedule and revised policies on telehealth and other reimbursements. But the potential 21.2% cut to payments driven by Medicare's sustainable growth-rate formula still looms.

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