Reimbursement
State officials had requested hospitals receiving payments and health plans reimbursing hospital providers to certify none of the contractual arrangements are above 120 percent of the Medicaid fee schedule, the allowable limit.
More than 2,100 healthcare providers have passed through the review stage and will begin taking on financial risk in the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement Initiative, the federal agency announced on Thursday.
One of the health law's key protections was to cap how much consumers can be required to pay out of pocket for medical care each year. Now some employers say the administration is unfairly changing the rules that determine how those limits are applied, and they're worried it will cost them more.
Employers say the administration is unfairly changing the rules that determine how those limits are applied, and they're worried it will cost them more.
CMS on Thursday said 360 organizations have directly entered into bundled payment agreements with the agency, and an additional 1,755 providers have partnered with those organizations as of July. But CMS acting administrator Andy Slavitt in June said there were more than 7,000 providers in the "at-risk" stage of the BPCI model.
As the clinical-financial relationship tightens, hospitals may want to consider whether they have appropriately organized their staffing roles and relationships to take the greatest advantage of the trend.
CenseoHealth accused of targeting those MAO plan members who were likely to yield the most serious diagnoses, and more likely to generate higher capitation payments.
Multiple bidders were involved in the deal.
The Centers for Medicare and Medicaid Services said it will delay releasing data on its risk corridor ratios for insurers participating in health insurance exchanges after it found several discrepancies in the data.
The Centers for Medicare and Medicaid Services said it will delay releasing data on its risk corridor ratios for insurers participating in health insurance exchanges after it found several discrepancies in the data.