As policymakers continue their search for solutions to lower healthcare costs, experts say it’s crucial that they target a major source of bloat: wasteful administrative spending.
Category: FierceMarkets
Insurers petition court to rehear risk-corridor case involving $12B in ACA payments
Six weeks after a devastating court ruling pulled the rug out from under a case involving $12 billion in the ACA’s risk-corridor program, Moda Health and Land of Lincoln are asking the Federal Court of Appeals to rehear it.
CMS proposes nixing pain-management questions from HCAHPS in response to opioid epidemic
The Centers for Medicare & Medicaid Services is planning to eliminate a set of questions on pain management from its nationwide patient experience survey, just months after rolling out updates to the questions.
Centene plans Medicare Advantage joint venture with Ascension
The announcement followed two other recent acquisitions by the insurer to boost its MA population, as well as favorable growth in Medicare overall this past quarter.
Payer Roundup—DOE breaks rule with healthcare tweet; Harvard Pilgrim, MyHealthMath announce partnership
The Department of Energy violated its purpose statute by promoting an anti-Obamacare editorial, according to the GAO. And Harvard Pilgrim Health Care announces a new partnership with MyHealthMath. Plus, more payer news to start your week.
12 attorneys general are suing the Trump administration over its association health plan rule. Here’s what you need to know
In addition to provisions written in the Affordable Care Act and the Employment Retirement Income Security Act, the complaint alleges the Department of Labor violated fundamental legal concepts, including separation of powers and legislative intent.
GAO audit finds CMS oversight of $171B in Medicaid managed care payments lacking
Despite the program integrity risks associated with managed care organizations, CMS’s oversight of the Medicaid program has focused disproportionately on fee-for-service arrangements, GAO says.
GAO audit finds CMS oversight of $171B in Medicaid managed care payments lacking
Despite the program integrity risks associated with managed care organizations, CMS’s oversight of the Medicaid program has focused disproportionately on fee-for-service arrangements, GAO says.
Hospital groups decry ‘draconian’ cuts proposed by CMS in OPPS rule
The Centers for Medicare & Medicaid Services issued its annual proposed rule setting outpatient payment rates, and industry groups are weighing in on plans for site-neutral payments and changes to the 340B program.
Payer Roundup—As midterms approach, pre-existing conditions are a top healthcare issue for voters
A recent poll asked voters about several hot-button issues around healthcare. Plus, House Democrats have set their sights on drug prices, and Mainers eligible for Medicaid under expansion begin to enroll in coverage as they await a state Supreme Court …
