Medicare & Medicaid

The Centers for Medicare and Medicaid Services has temporarily suspended its review of short stay patient claims to give reviewers time to improve the standardization around the two midnight rule, CMS said in a June 6 update.

In a new rule issued Wednesday, CMS is shutting down loopholes that allow short-term plans to operate outside the policies governing the ACA's single risk pool.

While reforms tied to the Affordable Care Act have most healthcare providers focusing on quality and efficiency, financial experts say the dramatic change in business model is driving improvement in credit ratings.

CMS has seen no adverse health outcomes due to the new fee schedule.

Eligibility for enrollment is being determined using pre-existing data from the Supplemental Nutrition Assistance Program.

WellCare Health Plans has completed its acquisition of Advicare Corp.'s Medicaid business, which includes the transfer of approximately 30,000 members to WellCare of South Carolina.

Seeking to improve patient safety and reduce hospital readmissions, the Centers for Medicare and Medicaid Services is readying a series of "Hospital Improvement and Innovation Networks" (HIINs).

Steven Lipstein, chief executive of BJC, which includes Barnes-Jewish hospital in St. Louis, said Medicare doesn't play fair because its formula for setting penalties does not factor in patients with socioeconomic disadvantages -- low-income, poor health habits and chronic illnesses for instance -- that contribute to repeated hospitalizations.

To continue progress towards a safer healthcare system, CMS is requesting proposals for the Hospital Improvement and Innovation Networks.

On Tuesday, the House Ways and Means Committee passed the "Helping Hospitals Improve Patient Care Act," a bill that, among other provisions, provides financial relief for hospitals that were in the process of building off-campus outpatient centers in 2015 when the reimbursement policy was changed.