HHS' outlier payment program has been subject to scrutiny after more than 100 hospitals manipulated data to score more reimbursement money for their exceptionally expensive patients.
A panel that advises HHS on outpatient hospital payments wants the CMS to drop a draft rule that could cut up to $1.65 billion out of the 340B discount drug program.
Providers get their chance this week to tell federal officials what they think of a plan to curtail spending in a popular, yet controversial, drug discount program.
Single-payer is likely a long way off in the U.S., but progressives want to talk about how it could be done.
The Trump administration's cancellation of two mandatory pay models could signal to providers that they can value volume over quality, experts say.
Facing a crushing caseload of appeals to denied Medicare claims, the CMS is launching a new audit process to reduce the number of providers that have their claims challenged.
The CMS is canceling two mandatory cardiac pay models that were supposed to start next year and is scaling back a joint replacement model that has already been implemented by hospitals across the country.
Providers increasingly are conducting advance care planning conversations with Medicare beneficiaries thanks to new CMS billing codes and a push to prepare early for patients' final days. The trend resulted in them drawing down $93 million in additional revenue last year.
When the 21st Century Cures Act last year included a provision requiring Medicare to account for patient backgrounds when it calculated hospital readmission penalties, safety net providers rejoiced.
A fast-growing Chicago company that provides primary care for the elderly has inked what could be a lucrative deal to join Aetna's Medicare Advantage network.
The 60-year-old Dallas-area doctor and six co-defendants defrauded Medicare and Medicaid out of almost $375 million by certifying 11,000 Medicare beneficiaries through home health providers. Their numbers would have made the doctor's Medicare practice the busiest in the country.
The Trump administration has placed a one-year moratorium on the so-called 25% rule, and hospitals hope it signals the end of a looming budget cut that they've been fighting for years.