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Medicare

Latest Headlines

Latest Headlines

California rehab hospital sues HHS over backlogged appeals for denied claims

The Casa Colina Hospital and Centers for Healthcare in Pomona, California, has filed a suit against the U.S. Department of Health and Human Services, claiming its backlogged process for resolving Medicare payment disputes has removed sorely needed revenue from its coffers.

CMS proposes to trim outpatient payments in 2016

The Centers for Medicare & Medicaid Services (CMS) proposed a modest trim to payments to hospitals for outpatient services and to ambulatory care providers for the 2016 calendar year, as well as a slight revision to the two-midnight rule,  MedPage Today has reported.

Medicare Part D plans cover majority of drugs used by dual-eligible consumers

Medicare Part D covers the bulk of medications commonly used by both Medicare and Medicaid beneficiaries, according to a new report from the Office of the Inspector General (OIG).

Community Health Network pays $20M to settle false claims charges

Community Health Network, a 200-facility health system headquartered in Indianapolis, has agreed to pay more than $20 million to settle claims that it improperly billed for surgeries performed at independent ambulatory surgery centers from the late 1990s to 2009, according to the U.S. Attorney's Office in the Southern District of Indiana.

Drug, medical device companies paid teaching hospitals, docs nearly $6.5B last year

The pharmaceutical and medical device industry contributed a shade under $6.5 billion to the nation's teaching hospitals and physicians last year, the Wall Street Journal has reported. That sum includes consulting services, research and promotional speeches about drugs. The money also included non-clinical payments, such as the value of free food provided to doctors by drug and medical device sales representatives.

Cancers, chronic conditions lack quality measures

Many chronic conditions--such as certain cancers--lack the proper representation in Medicare pay-for-quality programs. 

3 keys to sustaining Medicare for another 50 years

Medicare is celebrating its 50th anniversary this year. Although the federal health program has made strides since its inception, there are also several challenges that lie ahead, former Sen. Tom Daschle wrote in a Health Affairs blog post.

CMS pays out $1.3 billion to settle disputed RAC claims

The Centers for Medicare & Medicaid Services is proceeding with its plan to settle disputed recovery audit contractor clawbacks with hospitals, paying 1,900 inpatient facilities a total of $1.3 billion as of the start of this month, the agency announced.

10 new 'breakthrough' drugs to cost $50B for Medicare, Medicaid over next decade

Medicare and Medicaid will have to spend almost $50 billion to cover just 10 new specialty medications in the next 10 years, according to a new report from Avalere Health.

CMS unveils final financial rules for ACOs

The Centers for Medicare & Medicaid Services last week released revised rules for the formation and participation of accountable care organizations in its shared savings plans.