Medicare & CMS

medicaid
Why Some States Declined to Expand Medicaid

The vast majority of healthcare organizations and professional groups support Medicaid expansion, the Obamacare initiative to widen eligibility for Medicaid to individuals earning up to 138% of the federal poverty level. To them, the benefits of expansion, such as less bad debt and uncollectible bills, better patient access to services,…

medicare
GAO: CMS Bidding Program Cuts down on DME Fraud

A new report from the GAO found that CMS’ competitive bidding program for durable medical equipment (DME) may have unexpectedly cut down on device fraud and overutilization. The program was initially launched in 2007 to ensure that Medicare paid for medical supplies and devices at reasonable market rates, which was…

Medicare and Medicaid Bundled Payments
Bundled Payments: Tipping Point in Value-Based Care?

The Centers for Medicare and Medicaid Services’ (CMS) latest bundled payments proposal takes a bold step toward addressing Medicare payment reform for some of the most common, complicated, and costly care scenarios in U.S. healthcare. The Bundled Payments for Care Improvement (BPCI) program was launched in 2011 based on provisions…

CMS Implements mandatory bundled payment program

The Bundled Payment for Care Improvement Initiative (BPCI) is a Centers for Medicare & Medicaid Services (CMS) program that allows healthcare providers to enter into new payment models that encourage lower cost while offering more coordinated and higher quality care across an entire patient episode. Instead of the traditional fee-for-service…

Medical Imaging Providers Face Medicare Cuts for Failure to Comply with New Standards

Beginning on January 1, 2016, Medicare will reduce payments for certain Computed Tomography (CT) scans carried out by equipment that fails to meet standards defined by MITA, the Medical Imaging & Technology Alliance, an industry group that represents medical imaging technology manufacturers.  Reimbursement cuts will only impact the technical component…

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