Medicare & Medicaid

Payers have until June 6 to submit documents for Medicare's Annual Election Period materials including the Annual Notification of Change, Evidence of Coverage and Summary of Benefits documents.

The proposal needs federal approval to modify the marketplace set up under the Affordable Care Act, which specifically prohibits such immigrants from joining the exchanges. Lara's bill SB10 would compel California to seek that approval.

The Centers for Medicare & Medicaid Services recently postponed its plan to release the new rating system, which would award one star to the worst-quality facilities and five stars to those with the best marks.

Proposed Medicare Part B drug payment models threaten medical practices and patients who are already financially strained due to the price of needed treatment, physicians told a House Energy and Commerce Committee Tuesday.

The nation in the next few years faces many important decisions about health care -- most of which have little to do with the controversial federal health law. Here are five issues candidates should be discussing, but largely are not.

Only 168 hospitals in the United States earned five stars in the latest Hospital Compare ratings from the Centers for Medicare and Medicaid Services, according to new data released last week.

Medicaid managed care programs remains vulnerable to improper payments to providers, according to a recent Government Accountability Report to a Senate Committee on Homeland Security and Governmental Affairs, since the information needed to screen providers for inclusion in the program is often fragmented and unavailable.

Just because it's hard to achieve a payer mix that better supports a health system's bottom line, it's not impossible.

Consultants hired by the health system that owns Nantucket Cottage Hospital in Massachusetts made several errors that led to lower wages being reported to Medicare for the hospital, which could potentially lead to a $160 million drop in federal Medicare payments over the next fiscal year for facilities across the state.

The delay will give CMS additional time to conduct focused consumer testing of how the star ratings are displayed on Healthcare.gov.