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Pennsylvania gets a green light to pursue Medicaid expansion under an alternative model

The Centers for Medicare and Medicaid Services (CMS) has approved Pennsylvania’s demonstration proposal to expand Medicaid to adults with incomes through 133 percent of the federal poverty line. The state is the 28th...more

9/8/2014 - CMS Healthcare Medicaid Expansion

Another Pioneer Leaves The West

Another withdrawal from the Medicare Pioneer Accountable Care Organization (ACO) program has occurred. Sharp Healthcare ACO, an affiliate of the Sharp integrated delivery system in San Diego, California, notified the Center...more

9/3/2014 - ACOs CMS Healthcare Medicare Shared Savings Program

Bundled Payments under the Affordable Care Act Continue to Gain Influence

The Center for Medicare and Medicaid Services (CMS) recently announced that it will add roughly 4,100 providers to the 2,400 existing providers testing the possible use of Medicare bundled payment contracts. Providers must...more

8/12/2014 - Affordable Care Act Bundling Rules CMS Employee Benefits Healthcare

CMS seeks to update payment rates and eligibility certification requirements in proposed rule for Medicare home health services

On July 7, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule updating Medicare’s Home Health Prospective Payment System payment rates for 2015....more

7/8/2014 - CMS Healthcare Home Health Care Medicare

Quantifying and addressing improper payments for Medicare evaluation and management services

A review of Medicare Part B claims for evaluation and management (E/M) services conducted by the Office of the Inspector General (OIG) has found that the program paid $6.7 billion in improper payments in 2010. This figure...more

6/3/2014 - CMS Evaluation and Management Services Healthcare Healthcare Professionals Medicare Medicare Part B OIG Overpayment Physicians

Proposed modifications to EHR Incentive Programs

Last year, HHS revised policies and definitions surrounding what constitutes certified EHR technology—required for meaningful use incentive program payment eligibility—from the 2011 Edition criteria to the 2014 Edition...more

5/28/2014 - CMS Data Protection EHR Healthcare HHS HIPAA PHI

Colorado pilots an integrated model for the Medicare and Medicaid dual-eligible population

Last week, the Centers for Medicare and Medicaid Services (CMS) announced that Colorado is joining its Financial Alignment Initiative to pilot a managed fee-for-service model for people enrolled in both Medicare and Medicaid...more

3/12/2014 - CMS Fee-for-Service Healthcare Medicaid Medicare

CMS Announces Participants in Bundled Payments for Care Improvement Initiative

The Centers for Medicare & Medicaid Services (CMS) recently announced that over 500 organizations will begin participating in the Bundled Payments for Care Improvement initiative. The large number of participating...more

3/1/2013 - ACOs Bundled Payments CMS Medicaid Medicare

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