Advocates say safety net hospitals are unfairly punished by new penalties for readmissions. Bellevue Hospital has found strategies to give it an edge in that battle.
Congress told Medicare to stop putting Social Security numbers on beneficiary cards. But some industry experts question whether it's wise to go through the trouble to replace them with a new Medicare-specific ID.
Major medical societies are urging the CMS to continue to allow a decades-old panel that hears appeals from providers who have been underpaid. The CMS, however, largely ignores its recommendations.
Despite news of reduced competition and higher premium rates, the federal government argues most consumers will be able to find marketplace coverage for $75 a month or less.
Leading consulting firms and a growing list of niche advisers are competing aggressively to help major insurers use big data to identify high-risk patients and manage their costs.
Not-for-profit co-ops and other small health plans have been the leading critics of risk adjustment. Now, Aetna is right behind them.
Spending on prescription drugs under the Medicare Part D program increased more than 17% in 2014 despite a claims increase of just 3%, and other news
The CMS shared the numbers in its second annual Part D data dump, which comes as rising drug costs have drawn widespread criticism. Under Medicare Part D in 2014, doctors wrote more than 1.4 billion prescriptions, together costing the program and beneficiaries more than $121 billion.
The CMS is probing whether providers and organizations are steering Medicare- or Medicaid-eligible patients toward the Affordable Care Act's insurance exchanges to receive higher reimbursement rates.
The monitoring doesn't have to become a burden for primary-care providers because it can be reviewed by secondary, qualified triage-level staff, observing from afar.
The CMS has issued an 11-page list of questions and answers to better guide providers in using ICD-10 codes when tighter guidelines come into effect this October.
Several states may be pocketing federal dollars to run hospitals that have been taken over by private companies, HHS' inspector general's office warned on Friday.
The drug with by far the highest cost, despite the lowest claim count of the 10 most expensive, was Gilead's hepatitis C treatment Sovaldi at more than $3.1 billion. Next were Nexium, which treats gastroesophageal reflux disease, and the cholesterol drug Crestor.