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Health Care Paradox: Medicare Penalizes Dozens of Hospitals It Also Gives Five Stars

KHN

The federal government has penalized 764 hospitals — including more than three dozen it simultaneously rates as among the best in the country — for having the highest numbers of patient infections and potentially avoidable complications. The total amount of the penalties is determined by how much each hospital bills Medicare.

Medicare 136
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MIPS 2024: Approved and Unapproved Policies in the Final Rule

p3care

The policy change perfectly aligns with the CMS’s plan for growth and the Medicare PI Program. Medicare CQMs for ACOs CMS has given the green light to the collection of Medicare Clinical Quality Measures (CQMs) for ACOs participating in the MSSP, specifically under the Medicare CQMs collection type.

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Health Care Paradox: Medicare Penalizes Dozens of Hospitals It Also Gives Five Stars

KHN

The federal government has penalized 764 hospitals — including more than three dozen it simultaneously rates as among the best in the country — for having the highest numbers of patient infections and potentially avoidable complications. The total amount of the penalties is determined by how much each hospital bills Medicare.

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HHS OIG Report On Prior Authorizations Under Medicare Advantage

Sheppard Health Law

Department of Health and Human Services Office of Inspector (“OIG”) released a report that studied prior authorization denials and payment denials by Medicare Advantage Organizations (“MAOs”) (the “Report”). Thirteen percent of denied prior authorization requests met Medicare coverage rules. The OIG Report. additional test results).

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Patients Facing Death Are Opting for a Lifesaving Heart Device — But at What Risk?

KHN

A Last-Resort Treatment Before he got a HeartMate 3 implanted in January 2022, Sid Covington, of Austin, Texas, said he had researched the device during years of medication therapy and cardiac rehabilitation to treat his congestive heart failure. “I looked at case studies.

Doctors 133
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Behavioral Health System Modernization along the Continuum

NASHP

North Carolina’s comprehensive behavioral health approach included efforts to increase uptake of CoCM through additional training and practice supports and Medicaid rate increases to 120% of Medicare rates for behavioral health providers. An action plan dashboard tracks targets. CMS’s Birth to 5: Watch Me Thrive!

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BREAKING NEWS: Emergency Regulation Requiring COVID-19 Vaccination Issued for Health Care Workers

Briggs Healthcare

The Biden-Harris Administration is requiring COVID-19 vaccination of eligible staff at health care facilities that participate in the Medicare and Medicaid programs. The regulation will create a consistent standard within Medicare and Medicaid while giving patients assurance of the vaccination status of those delivering care.