A federal judge ruled the federal government hadn't shown that statements the insurer made about billing data accuracy would have affected payment of the claims.
During his six years at the CMS, Dr. Patrick Conway oversaw the agency's big push into value-based reimbursement. While he's now removed from rulemaking, Conway remains passionate about the idea of linking payment to outcomes.
The CMS has unveiled a new voluntary bundled-payment model that will be considered an advanced alternative payment model under MACRA.
Congressional Republicans are still actively trying to dismantle the Affordable Care Act, most recently folding repeal of the individual mandate into the tax reform bill. Instead of "repeal and replace," the strategy appears to be "co-opt and confuse."
The general counsel, acting with four others, falsified expenditure reports submitted to the agency that runs Florida's Medicaid program.
Provider groups called on the CMS to create more opportunities for physicians to participate in existing and new alternative payment models to advance the Innovation Center's mission of moving healthcare delivery from volume to value.
The CMS is asking for feedback on ways to promote competition in the market, enhance provider choice, encourage patient feedback and improve price transparency.
Under the Accountable Health Communities model, organizations will test ways to improve collaboration between healthcare providers and the local community and better address the social determinants of health.
Changes to the Affordable Care Act are inevitable in 2017. One often mentioned ACA target is the Center for Medicare & Medicaid Innovation, Medicare's test-bed for value-based payment models.
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The CMS is about to try rewarding hospitals that can get eligible patients to show up for cardiac rehabilitation. But cardiologists think it will take something more creative than financial incentives to get some patients to go.
“The process and scope were the downfall of the model,” said Jennifer Snow of AmerisourceBergen Corp., a drug distribution and services company. Opponents of the program said it upset the balance between the executive and legislative branches.