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Providers must report Medicare overpayments going back six, not 10 years

Providers must report Medicare overpayments going back six, not 10 years

By Virgil Dickson  |  February 11, 2016

The CMS has finalized a controversial rule that will require providers to return Medicare overpayments. The rule, first proposed in 2012, alarmed many healthcare organizations when it floated the idea that providers would be liable for returning Medicare overpayments going back as far as 10 years.

CMS may overhaul enrollment process, could include questions about sexual orientation

By Virgil Dickson  |  February 08, 2016

As the CMS seeks to simplify the application process for exchange plans and Medicaid, payers want to make it harder for individuals to sign up after open enrollment ends. Meanwhile, advocates and providers want to reduce barriers and have the CMS learn more about who is signing up, including their...

ACA  enrollment pleases HHS, but insurers have some complaints

ACA enrollment pleases HHS, but insurers have some complaints

By Bob Herman  |  February 06, 2016

HHS says that 12.7 million people signed up for 2016 coverage through the insurance exchanges, well within previously stated expectations. Now the Obama administration must ensure that the risk pool evens out so that premiums will stabilize and insurers will remain interested in selling the plans.

The health insurance industry's identity crisis

The health insurance industry's identity crisis

By Bob Herman  |  January 30, 2016

Most insurers have embraced the ACA, and it has helped many of them financially through the tacit encouragement of products such as high-deductible plans. But many still puzzle over how to pivot beyond what was long the core of their business: employer-based plans and holding down medical claims.

'Don't think you can turn into or develop a health plan on a dime'

'Don't think you can turn into or develop a health plan on a dime'

By Modern Healthcare  |  January 30, 2016

Mary Brainerd, CEO of HealthPartners, discusses her system's foray into insurance, the challenges faced by providers that want to make similar moves and her own experience in the healthcare system as a patient with breast cancer. She spoke with Modern Healthcare reporter Bob Herman.

The new basic training for next gen physicians

The new basic training for next gen physicians

By Michael Sandler  |  January 30, 2016

A growing number of medical schools in the U.S. are immersing students in the nitty-gritty of direct patient contact and care from the start of their training. The schools' aim is to produce physicians who are more in tune with team-based and patient-centered care.

CMS proposes changing ACO benchmarks

CMS proposes changing ACO benchmarks

By Virgil Dickson  |  January 30, 2016

The CMS wants to change how it evaluates whether the Medicare Shared Savings Program's accountable care organizations save money. The agency proposes moving away from assessing ACO benchmarks based on historical spending. It instead would analyze trends in regional fee-for-service costs.

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