Medicare & Medicaid

Touting the benefits of the Affordable Care Act to cover Americans who otherwise would not have healthcare plans, the Centers for Medicare and Medicaid Services on Tuesday said the median deductible for marketplace coverage in 2016 is $850, down from $900 in 2015.

Many babies born to mothers who are covered by Medicaid are automatically eligible for that coverage during the first year of their lives. In a handful of states, the same is true for babies born to women covered by the Children's Health Insurance Program. Yet, this smart approach is routinely undermined by another federal policy that requires babies' eligibility be reevaluated on their first birthday. Although they're likely still eligible for coverage, many of these toddlers fall through the cracks.

The measure preserving the State Health Insurance Assistance Program, known as SHIP, is part of a massive spending bill for federal health, education and labor programs, approved by the Republican majority of the House appropriations subcommittee that oversees those departments.

The Centers for Medicare and Medicaid Services has proposed changes to how it pays doctors and other providers for primary care with a new focus on care management and behavioral health.

The hospital groups urge CMS to address what they say are several significant underlying methodological problems with the program.

CMS is now calling for clinicians, hospitals, and critical access hospitals to use a 90-day EHR reporting period in 2016 - down from a full calendar year for returning participants in the government's EHR Incentive Program. They also proposed lowering the bar for achieving Stage 3 objectives, eliminating the Clinical Decision Support and Computerized Provider Order Entry objectives and measures for eligible hospitals and critical access hospitals.

Parents who say their children with autism are legally entitled to applied behavioral analysis -- or ABA -- treatment are butting heads with Texas officials. And without Medicaid coverage, they must either forgo the therapy or find a way to pay for individual insurance plans that help pick up the costs.

Proposal would eliminate any potential financial pressure clinicians may feel to over-prescribe pain medications, especially opioids.

American Hospital Association-backed report says ignoring socioeconomic differences may create the appearance of quality issues where there are none.

Many clinicians report feeling pressure to overprescribe opioids because scores on the pain management questions are tied to Medicare payments.