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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.

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.

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.

CMS grants Texas' short-term Medicaid waiver extension

By Virgil Dickson  |  May 03, 2016

The CMS has awarded Texas a 15-month extension waiver that would help cover the unpaid bills of Medicaid-eligible and uninsured patients in the state. The extension prolongs a standoff between Texas and the White House, which was hoping to instead see the state expand Medicaid.

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.

Q&A: 'Drug prices are the wrong target,' says PhRMA chief

Q&A: 'Drug prices are the wrong target,' says PhRMA chief

By Modern Healthcare  |  April 30, 2016

A nimble inside-the-Beltway operative, Stephen Ubl took the reins of the Pharmaceutical Research and Manufacturers of America just as outrage over high drug prices was hitting its peak. In an interview with Modern Healthcare Editor Merrill Goozner, Ubl shares his views on the drug-price debate.

Medicaid's unmanaged managed care

By Bob Herman  |  April 30, 2016

A new federal rule will encourage states to ramp up auditing of Medicaid managed-care insurers, many of which keep their medical spending hidden from public view.

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.

How Medicare's new payment overhaul tries to change how docs use tech

By Adam Rubenfire  |  April 30, 2016

Medicare's new system for paying physicians will kill off the so-called “meaningful use” regime the government has used for the past five years to judge whether providers deserved to be rewarded for using electronic health records.

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