The program, called Digital Bridge, will leverage Icario's expertise in personalized health communications to help plans ensure members are able to access resources available to get low-cost or free broadband.
Biogen’s Alzheimer’s disease drug Aduhelm will only be covered for Medicare beneficiaries participating in a clinical trial. The final coverage determination will have the effect of limiting use of the drug, but the agency said its decision provides clarity on what drug companies need to show in order to secure Medicare coverage.
As technology advances, AI-powered tools will increasingly reduce the administrative burdens on healthcare providers.
The Centers for Medicare and Medicaid Services announced the national coverage determination Thursday, expanding coverage for low-dose computed tomography for Medicare patients in line with current recommendations from the U.S. Preventative Services Task Force.
Not all drugs will be subject to price negotiation under the revised legislation. But the agreement sets up a framework enabling Medicare to negotiate the prices of medicines that have been on the market for a long time, and also caps the monthly price of insulin, which has been a flashpoint of drug price debate.
Recent efforts to improve transparency haven't made much of a difference, one author noted. But earlier reforms made a dent the "most egregious" practices.
The lack of an overarching CMS reimbursement policy on CAR T-Cell therapy has meant that coverage decisions have generally landed on the desk of local Medicare Administrative Contractors.
3D medical animation services have emerged as a groundbreaking tool in the healthcare industry, revolutionizing the way medical concepts are taught, understood, and marketed.
The report from the Inspector General comes amid increasing scrutiny of Medicare Advantage organizations for potentially overcharging the government for services.
On February 2, CMS said it has chosen to call off the Direct Decision Support Model. This follows a similar decision last year to cancel the Shared Decision Making Model.
Mylan settled with the U.S. Department of Justice to head off potential Medicaid liability claims by federal and state governments.
This would bring the EHR incentive program more in line with proposed rules for implementing MACRA, to be phased in starting next year.
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.
The report from the Government Accountability Office, said the backlog “shows no signs of abating.” It called for the Department of Health and Human Services to improve its oversight of the process and to streamline appeals so that prior decisions are taken into account and repetitive claims are handled more efficiently.
The aim, the government says, is to maintain quality while slowing spending in Medicare Part B by more closely tying payments to how well drugs work, using methods drugmakers, insurers and benefit managers are already trying in the private sector.
The 231 hospitals the study identified had below average scores on quality measures but were awarded the bonuses because caring for their patients during their stays and in the 30 days following their discharge cost Medicare less than what it cost at half of hospitals evaluated in the program.
Right on cue, an HHS agency dropped some news just as everyone was taking off for a long weekend. This time, the CMS waited until just before Thanksgiving to update its strategy for moving away from fee-for-service payments.
Andy Slavitt, who has served as acting administrator of the Centers for Medicare and Medicaid Services since the beginning of March, has been nominated to be permanent head of the agency. Already, some key Republicans have expressed concern because of Slavitt's ties to the troubled HealthCare.gov insurance marketplace, a symbol of GOP opposition to the Affordable Care Act.