The Centers for Medicare & Medicaid Services Friday finalized changes to the Medicare Advantage and prescription drug programs for contract year 2020. Specifically, the final rule implements Bipartisan Budget Act of 2018 provisions that expanded MA coverage of telehealth services, and policies to better integrate coverage for Medicare and Medicaid dual-eligible beneficiaries. The rule also includes updates to the MA and Part D Quality Rating System and to certain program integrity provisions. CMS estimates the final rule will result in $4.5 billion in savings over 10 years, largely due to recovery of overpayments to MA plans. CMS did not finalize its proposed MA risk adjustment data validation provisions, which it intends to address in a future final rule.

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The Centers for Medicare & Medicaid Services has begun collecting private payor rate data through its Fee-for-Service Data Collection System Clinical Lab…
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Sens. Chuck Grassley, R-Iowa, and Michael Bennet, D-Colo., April 30 introduced the Rural Community Hospital Demonstration Reauthorization Act, legislation that…
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The Centers for Medicare & Medicaid Services and the Food and Drug Administration April 23 announced a new pathway to expedite access to certain FDA-…
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In think‑tank reports, like the one released this week by Paragon Health Institute, hospitals are often reduced to abstractions — payment rates, charts,…
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As published April 20, the Department of Justice released an interim final rule in the Federal Register to delay compliance dates for states and local…
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The AHA today released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and…