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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

AFFORDABLE CARE ACT HELPING CONSUMERS GET BETTER VALUE FOR THEIR HEALTH CARE DOLLARS

Today, the Centers for Medicare & Medicaid Services (CMS) issued a final regulation that will ensure health insurance companies spend at least 80 percent of consumers’ health insurance premiums on medical care, not income, overhead and marketing.
Press Release

CMS ADOPTS POLICY AND PAYMENT CHANGES FOR OUTPATIENT CARE IN HOSPITALS AND AMBULATORY SURGICAL CENTERS

The Centers for Medicare & Medicaid Services (CMS) today issued a final rule with comment period (final rule) that will update payment policies and payment rates for services furnished to Medicare beneficiaries in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) beginning Jan. 1, 2012.
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

AFFORDABLE CARE ACT TO HELP IMPROVE CARE FOR MEDICARE BENEFICIARIES

Thanks to the Affordable Care Act, 500 community health centers in 44 States across the country will receive approximately $42 million over three years to improve the coordination and quality of care they deliver to people with Medicare and other patients, the Department of Health and Human Services announced today.
Press Release

HHS ANNOUNCES NEW INCENTIVES FOR PROVIDERS TO WORK TOGETHER THROUGH ACCOUNTABLE CARE ORGANIZATIONS

People with Medicare will be able to benefit from a new program designed to encourage primary care doctors, specialists, hospitals, and other health care providers to coordinate their care under a final regulation issued today by the Department of Health and Human Services (HHS).
Press Release

CMS PROPOSES IMPROVEMENTS TO MEDICARE

The Centers for Medicare & Medicaid (CMS) has proposed revisions to the Medicare Advantage program and prescription drug benefit program (Part D) that would implement new benefits under the Affordable Care Act and increase patient protections.
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