Policy and Legislation

The ACA created the Center for Medicare and Medicaid Innovation to launch experiments in every state, changing the way doctors and hospitals are paid, building networks between caregivers and training them to intervene before chronic illness gets worse, but one of the biggest experiments is the center itself.

The Department of Health and Human Services announced today that providers, payers and clearinghouses must transition to the classification system by Oct. 1, 2015.

Medicare's Hospital Insurance Trust Fund won't run out of money until 2030. That's four years later than projected last year and 13 years later than projected the year before the passage of the Affordable Care Act.

A Pennsylvania provider is suing a health insurance company for passing on its 2 percent reimbursement cut required by sequestration.

Although a May 2014 U.S. District Court ruling vacated HRSA's 340B orphan drug regulation, the agency has issued an interpretive rule affirming its policy on the orphan drug exemption. The pharma industry is up in arms, but what does it all mean?

If we can identify the "underlying path" of health spending, we can do a better job of predicting the future from a noisy history. This underlying path can also serve as the curve to be monitored for evidence of any "bend."

If we don't fundamentally change the way we pay for healthcare, we won't change the economic principles that continue to drive the rapid growth in healthcare spending. Let's pay physicians and hospitals based on the health problems their patients have.

Hospices can now lose Medicare payments if they don’t file cost reports, and yet, because there are no penalties for inaccurate reporting, there is little motivation to spend much time on them.

Medicare regulators are updating hospital outpatient and ambulatory surgery center payments for next year, and also outlining a potential remedy to private Medicare overpayments.

A quarter of the nation's hospitals in October will receive lower Medicare payments because their rates of patient complications are higher than their peers. Here is an explanation of the three measures Medicare is using to calculate the hospital-acquired conditions scores.