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CMS plans new website to better track fraud

By Virgil Dickson  |  May 26, 2015

The CMS wants to launch a system to track enforcement actions against Medicare providers over questionable claims. Fraud costs the federal government an estimated $60 billion to $90 billion annually.

Drugmakers funnel payments to high-prescribing doctors

Drugmakers funnel payments to high-prescribing doctors

By Bob Herman  |  May 23, 2015

Nearly one-quarter of Medicare's top-prescribing physicians received consulting fees or other financial perks from manufacturers of the drugs they prescribed in 2013, renewing nagging questions about conflicts of interest in medical decisionmaking.

From the publisher: Happy anniversary, Medicare and Medicaid

From the publisher: Happy anniversary, Medicare and Medicaid

By Fawn Lopez  |  May 23, 2015

Modern Healthcare has documented every Medicare and Medicaid milestone and challenge since Crain Communications purchased the magazine in 1976. This section commemorates the programs' 50th anniversary by providing some history and an overview of their challenges.

Demands of an aging population will have Medicare, Medicaid fighting for dollars

By Merrill Goozner  |  May 23, 2015

Medicare and Medicaid evolved in dramatically different ways. Medicare, which provided health coverage for seniors, became the third rail of American politics. Medicaid, a state-based program that provided health coverage for the poor, existed in a political netherworld. All that is about to change.

Uncapped programs fuel vast expansion of healthcare sector

Uncapped programs fuel vast expansion of healthcare sector

By Steven Ross Johnson  |  May 23, 2015

Medicare and Medicaid have precipitated the vast expansion—and even the creation—of many profitable industry sectors including hospitals, physician groups, managed-care insurers, home health, drug manufacturers, devicemakers and others.

Summit to examine physician concerns about bundled payments

By Virgil Dickson  |  May 23, 2015

Providers and policymakers will explore implementation strategies for bundled-payment models and address physician concerns about the CMS' bundled-payment experiments at the Fifth National Bundled Payment Summit in Washington.

CMS to release Medicaid managed-care rule

By Virgil Dickson  |  May 23, 2015

The CMS is about to release a sweeping proposed rule that could fuel a major expansion of Medicaid managed long-term care for elderly and disabled beneficiaries.

ASCO proposes reformed pay model for cancer care

By Sabriya Rice  |  May 23, 2015

Oncologists have proposed a new payment model for cancer care using consolidated billing codes, bundled payments and care-management fees, which they hope will improve quality of care and reduce costs.

CMS signals change in stance over Florida Medicaid waiver

By Virgil Dickson  |  May 23, 2015

The CMS is appearing to blink in its stare-down with Florida over Medicaid expansion. The agency informed state officials last week that it tentatively plans to renew a waiver that has provided Florida billions in supplemental Medicaid funding to help hospitals with uncompensated-care costs.

Medicaid a lifeline for the poor and disabled

Medicaid a lifeline for the poor and disabled

By Virgil Dickson  |  May 23, 2015

Before Medicaid was established, low-income Americans had limited access to healthcare, relying heavily on charity care and public hospitals. "To be old and poor and sick was to suffer and to die prematurely,” said Trish Riley of the National Academy for State Health Policy.

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