CMS Proposes Sweeping Changes to Restore Doctor-Patient Relationship

Talk to any healthcare provider and one of the things you likely will hear is that they spend too much time on paperwork and not enough time with patients. The Centers for Medicare & Medicaid Services (CMS) says it wants to change that. Earlier this month, the agency that administers the Medicare program proposed what […]

CMS Policy Changes to Drug Benefit Program Targets Opioid Abuse

Effective June 15, policy changes for the prescription drug benefit program finalized by the Centers for Medicare & Medicaid (CMS) take effect. CMS published the final rule updating Medicare Advantage (MA) and the prescription drug benefit program (Part D).  The new rule is expected to result in nearly $300 million in annual savings over five […]

HHS Takes Another Shot at Reducing Medicare Appeals Backlog

In an effort to clear the ever-growing Medicare appeals backlog, the U.S. Department of Health & Human Services has announced the launch of two new settlement options for providers and suppliers: a low-volume appeals (LVA) settlement and an expanded Settlement Conference Facilitation (SCF) process. LVA will be limited to appellants with a low volume of […]

GAO: CMS Fraud Prevention Working

The days of “pay and chase” in the world of healthcare fraud are waning thanks to fraud prevention methods that the Centers for Medicare and Medicaid Services have put into place. A newly released report from the Government Accountability Office (GAO) finds that Fraud Prevention System (FPS), which analyzes fee-for-service claims to identify healthcare providers […]

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