Medicare & Medicaid
CMS says limiting healthcare-related taxes and closing tax loopholes will save taxpayers $200B over 10 years.
Providers in the six states of the pilot will need to do advanced administrative processing to ensure claims are approved, says Jeff Ladner, chief product officer at Onspring.
The monthly premium for Medicare Part B will be $202.90 for 2026, an increase of $17.90 from $185 in 2025.
“Level of severity review,” which determines reimbursement, has drawn the ire of the American Hospital Association.
The model will offer round-the-clock services for behavioral health and social care in the greater Cincinnati and Toledo areas.
The CR would extend Medicare telehealth flexibilities, including acute hospital care at home and allow for retroactive payments.
Expected drop in next year’s star ratings will be due to the health equity index that includes social risk factors in CMS calculations.
AHA has “substantial concerns” over the vendor payment structure in WISEeR that incentivizes denials at the expense of physician judgment.
States are asked to send letters of intent to apply for the GENEROUS model that launches in 2026.
One health system told the ATA it would cost $1 million a year to comply with the billing mandates of the physician fee schedule final rule.