Medicare & Medicaid
MA enrollment is projected to increase while plans offer new types of supplemental benefits, CMS says.
About 90 percent of New York hospitals will be penalized next year, and while that number is high, it's down 3 percent from 2018.
Government alleged HMA unlawfully boosted inpatient admissions, submitted inflated claims to government payers and paid physician kickbacks for referrals.
In addition to those whose scores were directly impacted, some clinicians will see small changes in their payment adjustment after reapplication of budget neutrality, CMS said.
Rule threatens the stability of hospitals which will face more uncompensated care costs, says America's Essential Hospitals.
AARP says "Part D bailout" would be a windfall for big pharma; PhRMA counters that proposed changes would undermine Part D's structure.
CMS has made it clear that it wants health systems to share the risk of cost and outcomes.
CMS levies reimbursement penalties against hospitals that underperform on 30-day readmission rates, leaving for-profit hospitals at a disadvantage.
PBMs have been dogged by controversy for years, and yet they've become a fixture -- which David Henka sees as a real problem.
It has funds for behavioral and mental health providers, for potential EHR incentives and for hospitals to better care for infants with neonatal abstinence syndrome.