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News
CMS locks in 2%+ payment bumps for SNFs, post-acute care providers
19+ hour, 7+ min ago (999+ words) The Centers for Medicare and Medicaid Services has finalized its payment updates to key post-acute care providers and inpatient psychiatric facilities. Skilled nursing facilities, inpatient rehabilitation facilities, hospices and IPFs all received a Medicare payment bump to their respective prospective…...
State-based subsidies saved some ACA Marketplace losses
1+ day, 19+ hour ago (825+ words) A new report from KFF outlines effectuated Affordable Care Act Marketplace enrollment, painting what the organization says is a clearer picture of how overall ACA coverage has changed this year. The analysis comes after previous reporting that ACA Marketplace signups…...
CMS fraud war room stops $203M in debated Medicaid payments
2+ day, 19+ hour ago (682+ words) The Centers for Medicare and Medicaid Services is already lauding a new Medicaid fraud effort to be successful in its first 90 days after identifying more than $203 million in potentially improper payments to the federal program. The Medicaid Fraud War Room…...
OIG calls on states to tamp down Medicaid provider fraud
3+ day, 19+ hour ago (652+ words) Flavijus Piliponis â stock.ado The HHS Office of Inspector General wants states to ensure stronger contractual obligations with Medicaid managed care organizations to flag Medicaid provider fraud, the agency wrote in a recent report. Specifically, OIG called for CMS…...
Pharma loses appeal to change 340B drug discounts to rebates
1+ week, 1+ day ago (714+ words) SirVectorr/istock via getty imag A federal appeals court has dealt a blow to pharmaceutical manufacturers' attempts to restructure the 340B drug discount program -- a decision that preserves billions of dollars in savings for safety-net hospitals and clinics. Issued on July…...
Physician pay cuts loom as CMS unveils major Medicare reforms
2+ week, 2+ day ago (1084+ words) Christian Delbert - stock.adobe. The Centers for Medicare & Medicaid Services has released the proposed rule for the Medicare Physician Fee Schedule for the 2027 calendar year, which federal leaders say contains some of the most significant Medicare reforms in years. The…...
Health plans fall short in maternity care member communication
2+ week, 3+ day ago (815+ words) Health plans and their pregnant members might agree that member communication is a priority, but they aren't on the same page about what good communication actually looks like, according to a new report from Sage Growth Partners. Member communication, particularly…...
Care continues shift to outpatient as hospital margins dip
2+ week, 3+ day ago (719+ words) Where hospital care happens is fundamentally shifting, according to the latest hospital financial performance data from Kaufman Hall. The healthcare consulting firm released its monthly National Hospital Flash Report yesterday, drawing on data from more than 1,300 hospitals. In addition to…...
AdaptHealth says hackers exfiltrated patient data in social engineering attack
3+ week, 1+ day ago (254+ words) Vitalii Gulenok/istock via Getty AdaptHealth, a nationwide supplier of home medical equipment, disclosed a data breach that impacted an undetermined number of patients, according to a Form 8-K filing with the U.S. Securities and Exchange Commission. The company partners with…...
ACA premiums set to surge 14% as tax credits expire
3+ week, 2+ day ago (810+ words) AndreyPopov/istock via Getty Ima Payers participating in the ACA Marketplace have proposed a median premium increase of 14% for 2027 -- the second-highest rate hike since 2018 -- as the expiration of enhanced premium tax credits reshapes their risk pools and leaves millions without…...