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United States District Court Ruling Puts Risk Adjustment On Hold

On February 28, 2018, the United States District Court for the District of New Mexico issued a decision invalidating use of the statewide average premium by the Center for Medicare & Medicaid Services (CMS) in the risk adjustment transfer formula established under section 1343 of the Patient Protection and Affordable Care Act for the 2014 – 2018 benefit years, pending further explanation of CMS’s reasons for operating the program in a budget neutral manner in those years.
Press Release

CMS ANNOUNCES POLICY, PAYMENT RATE CHANGES FOR THE PHYSICIAN FEE SCHEDULE IN 2012

The Centers for Medicare & Medicaid Services (CMS) today issued a final rule with comment period that updates payment policies and rates for physicians and nonphysician practitioners (NPPs) for services paid under the Medicare Physician Fee Schedule (MPFS) in calendar year (CY) 2012.
Press Release

PHYSICIAN GROUP PRACTICE DEMONSTRATION SUCCEEDS IN IMPROVING QUALITY AND REDUCING COSTS

Today the Centers for Medicare and Medicaid Services (CMS) announced results from the initial Physician Group Practice (PGP) Demonstration, a landmark partnership with physician group practices that aims to better coordinate care across different settings, leading to improved quality and cost savings.
Press Release

CMS ANNOUNCES MORE ACCURATE FY 2012 PAYMENTS FOR MEDICARE SKILLED NURSING FACILITIES

The Centers for Medicare & Medicaid Services (CMS) today announced a final rule reducing Medicare skilled nursing facility (SNF) Prospective Payment System (PPS) payments in FY 2012 by $3.87 billion, or 11.1 percent lower than payments for FY 2011.
Press Release

NEW TECHNOLOGY TO HELP FIGHT MEDICARE FRAUD

On the heels of the White House launch of the Campaign to Cut Waste - an administration wide initiative to crack down on waste, fraud and abuse, the Centers for Medicare & Medicaid Services (CMS) announced today that starting July 1, it will begin using innovative predictive modeling technology to fight Medicare fraud.
Press Release

AFFORDABLE CARE ACT PROGRAM TO IMPROVE HOSPITAL CARE FOR PATIENTS

The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule that would establish a new hospital value-based purchasing program that would reward hospitals for providing high quality, safe care for patients.
Press Release