Policy and Legislation
A coordinated takedown by Medicare Fraud Strike Force operations in seven cities resulted in fraud charges against 107 people announced the Department of Justice and the U.S. Department of Health and Human Services on Wednesday.
With the future of the health reform law in the hands of the U.S. Supreme Court, a majority of hospitals and health systems are anticipating a drop in revenue as a result of the Affordable Care Act (ACA).
Not satisfied with having cut nearly half of the $6 billion allotted under the Affordable Care Act to help create health CO-OPs, the House Energy and Commerce Committee last week voted to defund the remaining $3.4 billion in the program.
Within a handful of miles of the birthplace of the American Revolution, a new revolution was being fomented the last week of April.
Under the Affordable Care Act, health plans have to issue rebates to policyholders if they don’t spend at least 80 or 85 percent of premiums on medical costs. Now that the law is in effect, about $1.3 billion is to be paid out.
The National Quality Forum (NQF) board of directors has endorsed two measures that address all-cause unplanned readmissions in hospitals -- an area of healthcare targeted for improvement given national imperatives to make healthcare safer, more affordable and keep people healthy.
A recent report by the Government Accountability Office (GAO) noted that oversight by the Centers for Medicare & Medicaid Services of state Medicaid managed care programs was inconsistent and did not ensure the quality of the data used to set rates.
The U.S. Department of Health and Human Services announced Thursday the finalization of the Community First Choice rule, a new state option under Medicaid.
A rule proposed by CMS Tuesday to update Medicare payment rates for acute-care hospitals would increase payment rates to hospitals by 0.9 percent in Fiscal Year 2013.
CMS announced its final rule for preventing Medicare fraud Tuesday, while the GAO issued a report requesting more action be taken.