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Hospitals resist CMS plans to police affiliations with banned providers

By Virgil Dickson  |  May 05, 2016

Hospitals are concerned about the administrative burden posed by a proposed CMS rule that would ban them from Medicare and Medicaid if they fail to disclose that they are working with providers or suppliers who have been barred from the programs or owe money to the government.

Michigan hospital back in Medicare's good graces

By Tom Henderson, Crain's Detroit Business  |  May 05, 2016

Officials for St. John Providence Health System were told Tuesday that St. John River District Hospital in St. Clair, Mich., is back in compliance with Medicare standards and a decision to terminate the hospital's participation in Medicare has been rescinded.

CMS requests doc input on MACRA

By Shannon Muchmore  |  May 04, 2016

CMS acting Administrator Andy Slavitt told the Physician-Focused Payment Model Technical Advisory Committee on Wednesday that the agency needs to hear ideas from providers in order to create successful alternative payment models.

CMS feels the heat to change Medicare Part B drug pay plan

CMS feels the heat to change Medicare Part B drug pay plan

By Virgil Dickson  |  May 04, 2016

The pressure is on for the CMS to transform or even drop its recently proposed plan to change the way it pays hospitals and doctors for outpatient drugs covered by Medicare Part B. Comments are flooding the agency, and most of the 600 opinions received so far are negative.

Tight MACRA deadlines could result in doc penalties

Tight MACRA deadlines could result in doc penalties

By Joseph Conn  |  May 03, 2016

Health IT experts say the tight timelines surrounding a new round of clinical quality and IT measures may result in penalties for some physicians if those measures require significant changes to electronic health records and other systems.

Docs call MACRA an improvement that has its own challenges

By Shannon Muchmore  |  May 03, 2016

Physicians speaking at the American Hospital Association annual meeting Tuesday said smaller practices in particular will have trouble with tight deadlines and substantial infrastructure requirements.

Miscalculation could cost Massachusetts hospitals $160 million

By Lisa Schencker  |  May 02, 2016

Massachusetts hospital leaders hope the CMS will overlook a miscalculation submitted by a small hospital there that could otherwise cost facilities across the state $160 million. Some experts, however, say the CMS may be reluctant to fix the mistake, out of fairness to other states.

Raising Medicare eligibility age would spike overall health spending

By Shannon Muchmore and Harris Meyer  |  May 02, 2016

A new report in Health Affairs argues that because private insurers pay more for services than Medicare, getting people between 65 and 67 on other plans would end up increasing healthcare spending across the country.

Docs face stark choices under new Medicare pay proposal

Docs face stark choices under new Medicare pay proposal

By Beth Kutscher  |  April 30, 2016

The new draft regulations designed to change how Medicare pays clinicians represent the most sweeping overhaul the CMS has made in a long time to the business of running a physician practice.

Medicare's new quality program targets measurement fatigue

By Sabriya Rice  |  April 30, 2016

The CMS is preparing to cull the number of quality metrics that physicians have to report as it rolls three quality-incentive programs into what Congress conceived as a more harmonized framework.

Aetna loses membership in Q1 but builds revenue

By Bob Herman  |  April 28, 2016

Aetna's total medical membership fell by almost a half million people since the start of the year, but the Hartford, Conn.-based health insurer was still able to build revenue.

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