Category Archive: FierceHealthPayer

CMS physician payment proposal nudges open the door for telehealth

Telehealth played a leading role in last week’s 1,473-page proposed rule from CMS that included several new virtual care reimbursement methodologies. Jennifer Breuer, a partner with Drinker Biddle, said the proposed rule is a “game-changer” if it’s fin…

Seeking clarity on racial disparities, Democrats ask insurers about maternal health coverage

More than 30 members of Congress signed letters to 15 major health insurers asking if and how their plans are working to reduce racial disparities in maternal mortality.

L.A. Care Health Plan is committing $31M to recruit primary care doctors

Publicly operated L.A. Care Health Plan has a new strategy in addressing a primary care physician shortage in Los Angeles. The insurer will commit $31 million to recruit doctors, putting money toward overcoming the financial hurdles that keep physician…

OIG: HHS needs to recoup $341K for former HHS Secretary Tom Price’s improper travel spending

The Department of Health and Human Services did not comply with federal regulations when it came to former HHS Secretary Tom Price’s government-related travel, according to an audit released on Friday. Here are the details.

CMS promises to ‘restore the doctor-patient relationship’ with 2019 proposed rule

CMS issued a proposed rule yesterday that makes what officials called “historic changes” to the Medicare program, including changes to E&M documentation requirements, new telehealth reimbursement opportunities and changes to the MIPS program.

Medicare Advantage beats fee-for-service in utilization, outcomes

A new analysis from Avalere shows Medicare Advantage patients have fewer inpatient stays, ER visits and avoidable hospitalizations than fee-for-service beneficiaries, despite higher rates of social and economic risk factors.

Doctors: Don’t blame me for high healthcare costs

Lots of factors are at play when it comes to high healthcare costs. But doctors are sure of one thing: They aren’t to blame.

Patients on ACA at higher risk for surprise bills, physician coalition says

Patients are at a higher risk of receiving surprise medical bills, as a new study found more health plans on the ACA insurance exchange markets offer restrictive networks.

Seema Verma defends cuts to ACA Navigator program, commitment to states’ ‘flexibility’

During a 30-minute Q&A session with reporters on Thursday morning, the CMS administrator also said states should continue to expect “flexibility” despite a Kentucky court ruling limiting its Medicaid work requirements rules.

House lawmakers take aim at family separations during HHS appropriations bill markup

Both Republicans and Democrats proposed amendments during an appropriations markup on Wednesday to address the concern of migrant children being separated from their parents at the border.

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