GAO Suggests CMS To Ensure Effective Use Of Medicaid Provisions

The Centers for Medicare and Medicaid Services (CMS) has taken the necessary steps in ensuring enough incentives for the states. This ensures that the billions of dollars received for the provision of Medicaid Managed Long Term Services and Supports (MLTSS) are put to use effectively. The Government Accountability Office (GAO) has made this official through…

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HHS Draft Rule To Address Insurance Market Issues Receives Mixed Reviews

A leaked rule from HHS, that is aimed to help stabilize the individual insurance market, reveals the narrow limits of Trump Administration on healthcare reform. It is reported that HHS has submitted a proposed rule to the Office of Management and Budget, but the details of the rule is not yet released. Only two different…

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MACRA And MIPS Preparation – What You Need To Know

CMS released the final rule that calls for significant legislative changes to the Medicare Access and CHIP Reauthorization Act (MACRA) in October 2016. MACRA repeals the Medicare Part B Sustainable Growth Rate (SGR) reimbursement formula and replaces it with Merit-Based Incentive Payment System or MIPS. As per MIPS, 85% of the Medicare reimbursements must be…

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Donald Trump’s Plans To Cut Unnecessary Healthcare Expenses

Donald Trump is elected as the next President of the United States of America for a reason. Among the promises made by him, the most notable one is the initiative to dismantle the Affordable Care Act, which is the most cherished legislation of the Left for the past eight years. Specifically, Trump promised to remove…

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The Healthcare Landscape Is Changing

Mergers and acquisitions have been the hot talks in the healthcare landscape for many months now. Health systems are merging, insurers are merging, and many hospitals are buying physician practices at unprecedented rates. Earlier in the 90’s, hospitals started buying up practices and employing doctors, but the result was not like what was expected by…

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CMS Needs To Resolve Vulnerabilities For The Success Of Quality Payment Program

Recent reports show considerable progress towards the implementation of the latest Quality Payment Program by CMS. This program is actually introduced to reward the providers for the value-based care they are offering to customers. However, reports claim that the CMS should address and resolve a few existing vulnerabilities for the success of this program. An…

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OIG Hopes To Recover $5.6 Billion In Fraudulent Spending

The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) recently submitted a Semi-Annual Report to the Congress. As per the report, the OIG is hopeful that they will be able to recover approximately $5.6 billion spent by the Federal healthcare programs in fraudulent spending in the year 2016. Reports indicate…

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How Trump Administration Would Affect Medicaid And ACA

We all know that Donald Trump will be occupying the White House on January 20, 2017 and the GOP will control both the houses of Congress. Trump has already selected Congressman Tom Price as the Secretary of HHS and Seema Verma as the Administrator of HHS. Before being elected to the Congress, Price was practicing…

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The 21st Century Cures Act Passed By Congress

Congress has been working in a bi-partisan way from 2015. They were working on an important medical innovation bill and the bill is intended to increase funding for the National Institutes of Health (NIH) while streamlining and reforming the Food and Drug Administration’s (FDA) approval process for the new devices and drugs. This bill is…

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Recent Release From CMS Hints Significant Increase In Medicare Premiums

The cost sharing amounts and 2017 premiums for Medicare Parts A and B was recently released by the Centers for Medicare and Medicaid Services (CMS). According to the agency, Medicare beneficiaries who are currently enrolled under Medicare Part B will have to pay a monthly premium just like the commercial insurers. Reports indicate that the…

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