Medicare & Medicaid

A program that has helped seniors understand the many intricacies of Medicare as well as save them millions of dollars would be eliminated by a budget bill overwhelmingly approved last week by the powerful Senate Appropriations Committee.

For years policymakers and the Centers for Medicare and Medicaid have hypothesized that better integration of healthcare services helps improve outcomes and lower costs. Now there is evidence to back up the claim, CMS officials said in a blog released Thursday.

The federal push reflects the continuing concern over the nation's rate of unintended pregnancies, which is one of the highest among developed countries. The costs are significant not only for the families involved but also for the federal and state governments.

In its June report to Congress, the Medicare Payment Advisory Commission warned that rising drug costs and other factors have helped drive Medicare Part D spending up nearly 60 percent from 2007 to 2014.

Following up on last week's announcement on strengthening the marketplace risk pool, the Centers for Medicare and Medicaid Services on Wednesday announced $22 million in funding for state insurance regulators to enforce Affordable Care Act consumer protections.

The law was a response to complaints from Medicare patients who were surprised to learn that although they had spent a few days in the hospital, they were there for observation and were not admitted. Observation patients are considered too sick to go home yet not sick enough to be admitted. They may pay higher charges than admitted patients and do not qualify for Medicare's nursing home coverage.

The Centers for Medicare and Medicaid Services on Monday proposed a new rule intended to reduce overuse of antibiotics, implement comprehensive requirements for infection prevention and prohibit discrimination.

CMS is awarding $10 million over the next three years to organizations that will help clinicians transition to the new quality payment system outlined under MACRA.

Fewer than one-quarter of hospitals in the United States are on track to hit the Obama administration's 2018 goal of providing at least half of their patient care through value-based arrangements -- structures that tie reimbursement from Medicare to the quality of care patients receive.

Despite interventions by Medicare officials, the number of appeals from health care providers and patients challenging denied claims continues to spiral, increasing the backlog of cases and delaying many decisions well beyond the timeframes set by law, according to a government study released Thursday.