Policy and Legislation

The Centers for Medicare & Medicaid Services on Monday said it will not deny claims under the Part B physician fee schedule based on ICD-10 coding errors, a decision supported by bitter ICD-10 opponent the American Medical Association.

CMS is proposing that physicians be able to make case-by-case exceptions to the rule, classifying certain short stays as inpatient so that they would be paid under Medicare Part A.

The law also requires that clinics meet the same standards as outpatient surgery centers, upgrades that can cost $1 million or more.

The study labeled 11 percent of plans "extra small" because they covered fewer than 10 percent of physicians in a plan's region. Another 30 percent were "small," meaning they covered between 10 and 25 percent of physicians.

King v. Burwell is closed, but the law's long-term future still isn't ensured.

Most organizations support the 6-3 vote to preserve federal subsidies.

The King v. Burwell ruling means more than six million residents in the 34 states with federal exchanges can keep their tax subsidies for healthcare insurance under the Affordable Care Act.

Oregon regulators are working with insurers to increase premiums, after a $127 million collective shortfall last year.

Some employers say a proposed rule could force them to cut the size of wellness programs’ financial incentives or penalties.

A scathing state audit shows that California is failing to make sure Medicaid managed care plans deliver their promises to patients.