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CMS Requests Feedback on Using Out-of-State Providers for Medicaid-Covered Children

CMS is requesting input from providers to determine “best practices for using out-of-state providers to provide care to children with medically complex conditions; determine how care is coordinated for such …

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The DOJ Recovers over $3 Billion from False Claims Act Cases in 2019

The Department of Justice obtained more than $3 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year ending Sept. …

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The Affordable Care Act’s (ACA) Individual Mandate is Unconstitutional

A federal appeals court ruled on Wednesday that the Affordable Care Act’s individual mandate is unconstitutional, but it stopped short of striking down the entire healthcare law. Two judges on the three-judge …

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CMS Releases 2018 National Health Expenditures

Total national healthcare spending in 2018 grew 4.6 percent, which was slower than the 5.4 percent overall economic growth as measured by Gross Domestic Product (GDP), according to a study …

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Big Tech Continues to Move Into Healthcare: Amazon Launches New Medical Transcription Service

Today Amazon launched a new product called Amazon Transcribe Medical, which is a healthcare-specific speech-to-text program. From Amazon: “Amazon Transcribe Medical uses machine learning to provide highly accurate automatic speech …

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The Trump Administration Releases Two New Rules on Price Transparency

Today the Trump Administration released a proposed rule and a final rule designed to increase price transparency through hospitals by giving patients tools to access pricing information through their health …

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Medicare Part A and Part B Premiums Increase for 2020

Each year the Medicare premiums, deductibles, and copayment rates are adjusted according to the Social Security Act. For 2020, the Medicare Part B monthly premiums and the annual deductible are …

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Health Plan Identifier Final Rule Release

HHS has announced a new rule, eliminating several regulatory requirements related to HIPAA. Health plans are no longer required to obtain and use a health plan identifier (HPID) and eliminates the …

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Healthcare.gov Premiums Are Down, but Are Still Unaffordable for Many

CMS announced that the average premium for the second lowest cost silver plan on HealthCare.gov for a 27 year-old will drop by 4 percent for the 2020 coverage year. Additionally, …

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Medicare Advantage Plans Ramp Up Marketing for Supplemental Benefits

Medicare Advantage enrollment has begun. Plans are taking advantage of the option to offer supplemental benefits to consumers. These benefits will likely be a significant source of growth as more …

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