Medicare & Medicaid
The lawsuit argues that Medicare is required to institute the payment model changes in a budget neutral manner.
Aspects of this proposed policy will affect nearly all hospitals paid under the Outpatient Prospective Payment System, CMS says.
Leqembi is the first amyloid beta-directed antibody to be converted from an accelerated approval to a traditional approval.
The concern is that the QBP overpays MA organizations and does not encourage quality improvement or help beneficiaries select plans.
The move makes South Dakota the 39th state, along with Washington, D.C., to adopt the ACA's Medicaid expansion.
The decrease is due in part to a permanent behavior assumption adjustment.
The list of the first 10 drugs covered under Part D selected for initial price applicability year 2026 will be announced September 1.
If a healthcare provider is out of compliance with CMS requirements, OIG may refer the matter to CMS.
The Enhancing Oncology Model offers additional payment for enhanced services to patients who are dually eligible for Medicare and Medicaid.
For hospital-based facilities, CMS projects an increase in total payments of 2.6%.