Medicare & Medicaid
While CMS says it is now allowing therapist assistants to perform services, Premier says the agency's definition requires a skilled professional.
Current rule makes no sense as it applies only to fee-for-service and most Medicaid beneficiaries are now served through managed care, stakeholders tell CMS.
Moody's credit analysts called the move positive for health insurers that own large PBMs.
CMS said it would encourage development of wearable or implantable artificial kidneys through cooperation between developers and the FDA.
The ACA is not a Jenga tower that will collapse upon removing the piece of the individual mandate, America's Health Insurance Plans argues.
Overall, hospitals in the CJR model saw a 3.7% decrease in average episode payments for lower extremity joint replacements.
Medicare Part D beneficiaries can have higher out-of-pocket spending for generics if they use expensive specialty drugs.
More than half of facilities met the expected level of staffing less than 20% of the time during the one-year study period.
HEDIS data underreported hospital admissions for at least three medical conditions, and the excluded admissions had higher readmission rates.
Patients in Medicaid expansion states shifted their ED usage toward more critical injuries and illnesses.