In an effort to improve outcomes at the nation's 6,000 dialysis facilities, Medicare plans to cut reimbursement rates up to 2% if the facilities perform poorly on an expanded set of quality metrics.
The CMS wants to cut reimbursement rates for outpatient services. Provider groups immediately slammed the proposals, saying they undervalue outpatient care.
The CMS proposed a 0.3% rate increase for end-stage renal disease services for 2016. The proposal also modifies Medicare's quality incentive program for dialysis providers.
The federal government has expanded its investigation into DaVita HealthCare Partners' Medicare Advantage risk-adjustment practices, DaVita revealed in a Securities and Exchange Commission filing Wednesday.
New CMS guidelines intended to ensure Medicaid managed care plans are adequately reimbursed will frustrate state agencies and create paperwork the CMS might not have the staff to handle, according to the National Association of Medicaid Directors.
HHS has signaled its intent to more rigorously enforce the anti-kickback statute against individual physicians who enter into improper payment deals, following a dozen recent civil settlements involving doctors.
The CMS paid out $1.3 billion to more than 1,900 hospitals as of June 1 as part of its efforts to clear out the Medicare payment-appeals process. But the fight over Medicare appeals has only intensified.
Hospitals contend that their high and extremely variable chargemaster prices shown in new CMS data are misleading because very few patients are asked to pay them. But the rates are a growing concern as more patients face unexpected out-of-network bills.
Medicare paid out hundreds of millions of dollars to a small subset of physicians in 2013, but most of those payments to top Medicare billers covered the costs of drugs administered to patients in clinicians' offices.
Imagine a company that produces a high-quality product, operates efficiently and generates $16 million in year-over-year savings. Then imagine that the company isn't allowed to retain those savings, but is assessed a penalty. Hard to imagine? Well, it's a reality in the U.S. healthcare system today.
The CMS should evaluate the work of their Medicare administrative contractors to increase efficiency and improve quality, the GAO says in a new report.
Federal investigators say the current process to review and recommend how Medicare pays doctors leaves it susceptible to inaccurate reporting and conflicts of interests.