California's health insurance rates for a new state-run marketplace came in lower than expected this week, but one downside for many consumers will be far fewer doctors and hospitals to choose from. People who want UCLA Medical Center and its doctors in their health...
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Government
California Unveils Qualified Health Plans, Expected Premiums for Health Benefits Exchange
Covered California, the state agency implementing the Affordable Care Act (ACA), has announced participating health insurers and proposed premiums for the state's exchange, which is expected to provide health insurance coverage to roughly 5 million Californians...
CMS Issues more In-Depth Survey Guidelines to Reduce Readmissions
The Centers for Medicare & Medicaid Services has revised the provider certification manual for hospitals, giving more in-depth guidelines around discharge planning. The goal is for hospitals to reduce readmissions by partnering with post-acute providers. The...
Did CMS Break Rules to Rig Bid Numbers?
Anybody who is paying any attention to the Medicare competitive bidding program understands that the program is fatally flawed. We all know that just about every qualified expert in the field of auction design has agreed that the program breaks just about every rule...
OIG Releases Updated Provider Self Disclosure Protocol
The Office of Inspector General ("OIG") of the Department of Health and Human Services ("HHS") has issued a revised version of its Provider Self-Disclosure Protocol ("Updated SDP"), dated April 17, 2013, which established a process for health care providers to...
Industry Casts Further Doubt on Bid Process
H.R. 1717 remains the HME industry’s No. 1 priority, but with time running out, stakeholders are again pressing for a delay in the July 1 start date of Round 2 of competitive bidding. The basis for that delay: a growing list of contract suppliers that appear to fail...
Tennessee Congressional Delegation Question Legality of Competitive Bidding
Members of the Tennessee United States Congressional delegation today called on the administration "to provide details on its policy of awarding Medicare contracts to businesses not licensed in Tennessee, a violation of the administration’s bid policy and a violation...
Blue Cross of Vermont Opens Health Exchange Education HQ
One out of every six Vermonters, about 100,000 people in a state of 630,000, must switch the way they enroll and buy for health insurance this fall with the opening of a federally mandated online marketplace called Vermont Health Connect. It’s a massive change...
Senators Introduce CRT Bill
WASHINGTON – Industry stakeholders now have bills in both the House of Representatives and the Senate to create a separate benefit for complex rehab technology (CRT). Sens. Chuck Schumer, D-N.Y., and Thad Cochran, R-Miss., introduced S. 948, the “Ensuring Access To...
CMS: Medicaid Disproportionate Share Hospital Allotment Payment Reductions
The Centers for Medicare & Medicaid Services (CMS) put on display at the Federal Register a Notice of Proposed Rulemaking titled “Medicaid Disproportionate Share Hospital Allotment Payment Reductions” (CMS-2367-P.) The Affordable Care Act requires...
US Senate Confirms Tavenner as Medicare/Medicaid Chief
The U.S. Senate on Wednesday confirmed Marilyn Tavenner, a former nurse and hospital company executive, as the first full-fledged administrator for the Medicare and Medicaid healthcare programs since 2006. In a rare show of bipartisanship on a healthcare issue,...
MPP Bill H.R. 1717 Up to 65 Sponsors
As providers prepare to head to Washington, D.C. for next week’s American Association for Homecare annual Washington Legislative Conference (May 22-23), H.R. 1717, the bill that would replace competitive bidding with the market pricing program (MPP) continues to gain...