Reimbursement
Ruling throws out 2014 rule, leading to question of how CMS will determine whether it has overpaid an MA insurer.
The insurer says it is owed $5 million in payments mandated under the Affordable Care Act.
The total spend increase for CRM devices is 8 percent, which translates to a $400 million estimated cost increase for hospitals.
Judge to decide whether loss of individual mandate is tied to keeping essential benefits for those with pre-existing conditions.
The analysis, done for PhRMA, found that 320 hospitals marked up some medicine prices more than 1,000 percent.
Bipartisan concern over Medicare policies driving hospital consolidation has been long-standing, but conflicting evidence has clouded the waters, lawmakers said.
Under the Emergency Medical Treatment and Active Labor Act, hospitals participating in Medicare are required to screen and stabilize emergency room patients.
Agency evaluation of Next Gen sets stage for ACOs to qualify as Advanced APMs under MACRA and get incentive payments.
It's possible to move beyond a one-size-fits-all approach to hospital ratings and toward one that takes into account individual needs and preferences.
There are potentially substantial financial benefits to be gleaned from sociodemographic adjustment for safety net hospitals.