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CMS tweaks ACO REACH to stabilize model

Health Care Dive

Regulators lowered enrollment minimums for accountable care organizations in the program, which allows providers to form groups to manage care and costs for fee-for-service Medicare enrollees.

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CMS Issues Final Rule to Protect Medicare, Strengthen Medicare Advantage and Hold Insurers Accountable   

Briggs Healthcare

Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), finalized the policies for the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program, which is CMS’s primary audit and oversight tool of MA program payments.

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How CMS’ Goal To Enroll All Medicare Beneficiaries In ACOs Could Impact Home-Based Care Providers

Home Health Care

Centers for Medicare & Medicaid Services (CMS) has stated its objective to enroll all of its Medicare beneficiaries in accountable care relationships by 2030. million Medicare fee-for-service beneficiaries are assigned to an ACO. Currently, roughly 13.2 We’d like to try it that way.’

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HIMSSCast: Whole person care and data interoperability drivers

Healthcare It News

Social determinants of health – the food, shelter and security attributes of patients that exist outside of care settings – contribute disproportionate risks for disease, hospital readmissions and a lack of access to quality healthcare among vulnerable populations, including people on Medicare.

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CMS Medicaid Proposals Offer Transparency And Accountability, But Compensation Provision Could Cap Business For Cash-Strapped Providers

Home Health Care

Centers for Medicare & Medicaid Services (CMS) proposed a new rule that would make major changes to the way that home care workers are compensated under Medicaid. It’s a step towards additional transparency and accountability, including state, payer and provider,” he told HHCN. “I On Thursday, the U.S.

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TRG Settles for $3.1M Over Alleged Improper Billing Practices

HIT Consultant

Improperly billed for services: The government alleges that TRG billed Medicare for radiology services performed by a radiologist located in the UK, which violates program regulations. Attorney Damian Williams.

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Home Care Industry Slams Finalized 80-20 Rule, Warns Agency Closures Are Coming

Home Health Care

A blanket rule that fails to take into account the different factors affecting HCBS in different markets across the country was – while well intended – a poor measure, according to some of the top home-based care leaders in the country. This is a developing story.

Home Care 115