Policy and Legislation

Pennsylvania is the first state to have a backup plan to prevent its residents from losing their health insurance subsidies should the U.S. Supreme Court strike down the federal exchange provision in the Affordable Care Act.

Ways & Means Committee members call upon CMS to make public a plan to avoid disruption of payment to providers and physicians after Oct. 1 implementation date for ICD-10.

More than 1.3 million Floridians received an average subsidy of $294 a month in March to reduce their premiums, according to the new data.

CMS said 85 percent of those were receiving a tax credit to help pay for the service, with the average credit being $272 per month. See the full breakdown of the data by state.

The company last year lost thousands of customers to the health law's online exchanges where consumers shop directly for plans and find out if they qualify for subsidies.

Smaller practices that may not have the capital to invest in systems and staff to manage the coding change may seek out mergers, joint ventures or other partnerships.

Among the major changes proposed for Medicaid plans are new provider adequacy standards, new mandates for capitated rate setting, beneficiary protections in long-term care, forthcoming quality ratings, and an 85 percent medical cost administrative ratio.

Depending on how much the program is reformed, it could mean the difference of hundreds of millions of dollars for the thousands of hospitals who get a drug discount.

The decline of CoOportunity Health of Iowa and Nebraska has Obamacare critics and executives at large insurers skeptical that co-ops can ever compete.

With the Oncology Care Model, participating practices will have their chemotherapy treatments tracked and measured for the necessity and outcome of the treatment, as well as the coordination of care that leads up to the cancer treatment.