Policy and Legislation
CMS is finalizing a new specific wage index that will be used to adjust payments for geographic differences in area wages.
MSSP earned shared savings payments totaling $3.1 billion, the highest since the program's inception.
Congress must enact permanent reform instead of making last-minute payment fixes each year, says MGMA.
Ivor Jallah, 37, pleaded guilty earlier this year and has been sentenced to 120 months in federal prison.
According to the AMA, this has undercut fair payment for out-of-network healthcare services and eliminated market competition.
Insurer is seeking an injunction, claiming the downgrade was based on an "arbitrary and capricious" assessment.
To date, New York has refunded approximately $10 million to the federal government and recovered roughly $19 million in unallowable payments.
The lower MA premiums are expected to drive enrollment to 35.7 million by 2025 - about 51% of all Medicare beneficiaries.