Medicare & Medicaid
In 2014, recovery auditors identified $2.39 billion in overpayments and $173.1 million in underpayments repaid to providers.
Medicare Advantage takes on capitated risk, so why don't these plans qualify as an advanced alternative payment model?
Payment differences have provided an incentive for hospitals to acquire physician offices.
The agency is also adding a three-item care transition dimension to the HCAHPS survey in 2018.
Home health agencies that do not submit quality measure data to CMS will see a 2 percent reduction in their annual payment.
Facilities that do not meet total performance scores will see up to a 2 percent reduction in the quality incentive program.
Premium assistance programs have come under fire from insurers.
Patient factors must weigh equally under Hospital Readmissions Reduction Program to avoid crippling penalties for safety-net facilities, study says.
Insurers can transfer customers who have purchased policies through an ACA insurance exchange, other commercial plans when they become eligible.
Incorrect information was found for almost half of the 5,832 doctors listed in directories for 54 Medicare Advantage plans checked last fall.