In the post-public health emergency (PHE) era, I have noticed what I think may be a glitch in the computer system at the Centers for Medicare & Medicaid Services (CMS).…
States that expanded Medicaid in 2014 saw a 45 percent decline in the mean flow of medical debt collections compared to states that chose not to expand Medicaid or those…
Are you prepared for the sweeping changes made to the “traditional” 1995 and 1997 evaluation and management (E/M) guidelines for office and outpatient visit codes you have been accustomed to…
Funding legislation aimed at keeping HHS and other non-Defense agencies running in fiscal year (FY) 2020 will also postpone $4 billion in Medicaid Disproportionate Share Hospital (DSH) payment cuts until…
The owner of a transportation company has pleaded guilty to fraudulently billing millions in false claims to the state’s Medicaid Program (MassHealth), Attorney General Maura Healey announced today. Michael Davini,…
Say goodbye to RUG-IV, and hello to the Patient-Driven Payment Model (PDPM). This is a daunting task, not for the faint of heart. Under PDPM, reimbursement for Medicare Part A…
Many readers may remember the Centers for Medicare & Medicaid Services (CMS) Transmittal 534. This was released in early August 2014, and it would have given Medicare contractors the ability…
For quite a long time, Medicare and Medicaid have been included on a Government Accountability Office (GAO) rundown of government programs that are at an expanded danger of misrepresentation, waste,…
In a boost for cardiovascular care in the U.S., new research shows those suffering heart attacks and strokes were less likely to be uninsured for their hospital stays after states…
Aiming to cut down on regulatory burdens and give more power to states, the Centers for Medicare & Medicaid Services is making notable changes to the Medicaid program, the biggest…
The CMS on Tuesday said it will toss two bundled-payment models and cut down the number of providers required to participate in a third, citing providers' requests to have more…
By the time the late President Lyndon B. Johnson signed the law establishing Medicare and Medicaid in 1965, the health care community was already figuring out how to maximize its…
The Centers for Medicare & Medicaid Services needs to step up its involvement in states' Medicaid integrity programs in order to strengthen oversight and identify overpayments, according to a new…
Addiction services may be a societal necessity – especially as the Central Massachusetts opioid crisis proves particularly fatal – but it is a business, and in this area of medicine,…
The Centers for Medicare & Medicaid Services has launched an online resource to support states' efforts to update outdated IT systems, Andy Slavitt, CMS' acting administrator, announced on Monday. Through…
Four state Medicaid programs have been approved by the Centers for Medicare & Medicaid Services to delay transitioning to ICD-10 codes by the Oct. 1 deadline. California, Louisiana, Maryland and…