Last week, CMS published a final rule implementing the ACA’s medical loss ratio (“MLR”) requirements that will apply to the Medicare Advantage (Part C) and prescription drug (Part D) programs beginning in contract year 2014. ...more
Earlier this week, the Kaiser Family Foundation and the Altarum Institute’s Center for Sustainable Health Spending published an analysis of the recent slowdown in health care spending. The study asserts that macroeconomic...more
After receiving many comments on its Draft Call Letter, CMS published its Contract Year 2014 Final Call Letter on April 1, 2013. The Final Call Letter addresses a wide variety of issues that will affect all parties involved...more
In Advisory Opinion 12-21, the OIG concluded that a Federally qualified health center’s offer of grocery store gift cards to capitated managed care patients would not constitute grounds for the imposition of sanctions under...more
Originally published in BNA’s Medicare Report, 11/30/2012.
On Oct. 12, the Centers for Medicare & Medicaid Services published its 2013 Medicare Health Plan Quality and Performance Ratings, also called ‘‘Star Ratings’’...more