Reimbursement

A large group of health, pharma and payer organizations are hoping to stop what some think are the most pernicious changes to Medicare Part D in the program's history.

The number of people determined eligible for Medicaid since the launch of new insurance marketplaces is approaching 10 million, a potential boon to managed care plans and safety providers even in states that are not expanding the program.

There's still plenty of work to do before the Oct. 1 ICD-10 deadline. A recent study found that only 4.8 percent of physician practices reported significant progress in overall ICD-10 readiness. Hospitals report higher levels, but many are still behind.

The number of people determined eligible for Medicaid since the launch of new insurance marketplaces is approaching 10 million, according to new data released from the Centers for Medicare & Medicaid Services.

When the new insurance tax hits Medicaid managed care plans this year, it will basically leave the government taxing itself and perhaps spur more states to start contracting with not-for-profits.

For state exchanges still struggling to function, and governors facing the consequences, the Centers for Medicare & Medicaid Services is offering an exception to the rule of tax credits only being available through public marketplaces.

The Obama Administration recovered a record $4.3 billion last year from fraudsters trying to dupe federal health programs, or those who sought payments to which they were not entitled.

Since 2008 when CMS first implemented the Hospital Consumer Assessment of Healthcare Providers and Systems survey for U.S. hospitals, the scores from these surveys have become increasingly more important to hospital executives as a measure of quality. They are now used to determine 30 percent of the total incentive under the Hospital Value Based Purchasing program.

As health systems around the nation buy up office-based physician practices and redub them outpatient facilities, Pennsylvania's largest insurer may be starting a competing trend with a new payment policy for one of the most profitable specialities.

The price of an initial inpatient stay explains almost all of the wide spending variation from hospital to hospital on episodes of care, such as for knee or hip replacements, the National Institute for Health Care Reform has found.