Author's posts
Medicare Advantage provider directories are riddled with errors. They’re not the only ones
Almost half of online Medicare Advantage directories contained incorrect or out-of-date information, CMS found in a recent investigation.
Top Democrat plans DOJ probe over refusal to defend the ACA in court
With a Texas judge set to make a ruling on the most-recent ACA case any day now, Democratic members of Congress are once again probing the Department of Justice’s refusal to defend the law in court. Only now, they have to deal with Acting Attorney Gene…
MACPAC urges Azar to pause, re-evaluate Arkansas’ Medicaid work requirements
Amid CMS’ encouragement of work requirements in state Medicaid programs, MACPAC told HHS Secretary Alex Azar that Arkansas’ implementation of the policy was too crude and hasty. It urged the state to pause disenrollments and reconsider certain paramete…
ACA had ‘no adverse impact’ on workers’ hours and wages: report
Back when the Affordable Care Act first introduced new mandates for individuals and employers, critics predicted businesses would respond by cutting workers’ pay and giving them fewer hours. According to a recent report by the Urban Institute, those fe…
Governors’ seats turn blue in Wisconsin and Kansas with Medicaid expansion on the line
At the state level, Democrats won upsets in several red-leaning gubernatorial races, notably in Kansas and Wisconsin. But given that statehouses there are still largely controlled by Republicans, the possibilities for Medicaid expansion may be slimmer …
With CMS’ new physician fee schedule on the way, 2018 could be a ‘turning point’ for telemedicine
WASHINGTON, D.C.—Even with new telehealth applications popping up every day, the central questions for doctors remain: Does it work, will I get sued and can I get paid? Advocates hope the CMS’ new physician fee schedule, expected to be finalized this w…
Payer Roundup—Democrats look to investigate Trump’s healthcare policies; Senators ask CBO to redo ACA estimates
Should they manage to retake the House, Democrats want to launch an investigation of the Trump administration’s health policy. Plus, GOP senators are asking the CBO to re-estimate ACA figures using a new model and other news from the health payer world.
Medicare Advantage insurers routinely issue improper payment denials, OIG finds
The HHS Office of Inspector General recommended that CMS become significantly more involved in overseeing Medicare Advantage organizations (MAOs) following a recent report. OIG found that MAOs routinely deny payment for services that should have been p…
Telehealth reimbursement uncertainty creating inequities in healthcare
Every day, more providers are integrating telehealth services for their patients. But without clarity over how payers will reimburse those services, the only people who can really take advantage are the ones who can pay out of pocket, a panel of health…
Report: A single day of downtime in CMS’ Enrollment Database would cost $47M
The Centers for Medicare & Medicaid Services needs to improve the cyber resiliency of its Enrollment Database, according to the Office of Inspector General. If not, the office warned the daily financial impact of a nonfunctional database could reach $4…
