The OIG said the improper payments to hospitals for intensity-modulated radiation therapy planning services ran afoul of Medicare Part B payment rules because those planning services were already covered in bundled payments for IMRT therapies.
Category: FierceMarkets
Blockchain in healthcare: 3 promising use cases in a sea of skepticism
WASHINGTON, D.C.—The recent Blockchain Health Summit brought arcane blockchain engineers, hopeful healthcare CEOs and a heady dose of hype to the nation’s capital. But a few promising healthcare use cases did emerge, alongside some not-so-promising one…
Payer Roundup—Arkansas Works putting coverage on the line; CMS approves New Jersey 1332 waiver
More than 5,200 Arkansans could lose Medicaid coverage next month due to the state’s new work requirement. Meanwhile, Seema Verma expressed her approval for New Jersey’s State Innovation Waiver with an emoji.
Report: To halt rising Part D costs, shift liability to drug companies and insurers
While the federal government would still pick up most of the tab, shifting the burden of high-cost patients would reduce out-of-pocket costs for beneficiaries, says the American Action Forum.
Verma calls on insurers to use APIs. Some answer more enthusiastically than others
For the second time this year, CMS Administrator Seema Verma called on insurers to follow the agency’s lead and release claims data in API format. Some insurers are more enthusiastic than others.
Ways and Means Committee targets physician burden with Medicare Red Tape Relief Project
The committee has spent the last year working to understand what “regulatory burden” means to providers. Now, it wants to act to help them.
Ohio cracks down on PBM contracts after audit shows egregious spread pricing in Medicaid
PBMs collected $224.8 million from taxpayers last year through the model, including more than $208 million on generic drugs. The state will no longer permit it, forcing PBMs to restructure their contracts.
KMG sale cost Humana nearly $800M
With the sale of KMG, Humana is no longer involved in the commercial long-term care industry. But the net loss was minimized by a healthy tax break.
Oscar, Centene plan to stock up on IT talent
Oscar’s CTO said the company will double its engineering and product development workforce after a funding round from Alphabet, and Centene plans to fill 300 highly skilled IT positions.
Grassley urges ‘careful analysis’ of healthcare mergers, citing drug supply chain consolidation
Some suspect the Senate Judiciary Committee, which he chairs, will hold hearings about the pending CVS-Aetna and Cigna-Express Scripts deals in the near future.
