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December 22, 2022

‘It’s finally here’: States have long sought Medicaid eligibility redetermination deadline

Robert King | December 22, 2022 States have been preparing for a while for when they must start redetermining the eligibility of Medicaid recipients. Now, a deadline is in sight: April 1. A must-pass omnibus spending package included a requirement for states to start eligibility redeterminations by April 1. The concrete deadline—combined with a gradual…

November 23, 2022

ACA sign-ups top 3M since start of open enrollment, a 17% bump compared to last year

Robert King | November 23, 2022 Nearly 3.4 million people have signed up for 2023 Affordable Care Act insurance coverage since the start of open enrollment on Nov. 1, a record-setting pace that is a 17% boost over last year, new federal data shows. The sign-up data, released Tuesday by the Centers for Medicare &…

November 03, 2022

CMS’ 3.8% pay bump for hospital outpatient services is ‘insufficient’ given cost pressures, AHA says

Alan Condon | November 3, 2022 CMS will increase hospital outpatient payment rates by 3.8 percent in 2023, but the American Hospital Association said the adjustment is “insufficient given the extraordinary cost pressures” from labor, supplies, equipment, drugs and other expenses. In its Outpatient Prospective Payment System final rule, released Nov. 1, CMS will increase…

November 03, 2022

CMS final rule cuts cardiology reimbursements: 3 takeaways

Mariah Taylor | November 3, 2022 CMS issued its final rule for the 2023 Physician Fee Schedule, which provides both good and bad news for cardiologists. “[It’s] a good news, bad news scenario. The good news is that the adjustments are less draconian than what had been initially proposed…. The bad news [is] reflective of…

November 01, 2022

Medicare fines for high hospital readmissions drop, but nearly 2,300 facilities are still penalized

Jordan Rau | November 1, 2022 The federal government has eased its annual punishments for hospitals with higher-than-expected readmission rates in an acknowledgment of the upheaval the COVID-19 pandemic has caused, resulting in the lightest penalties since 2014. The Hospital Readmissions Reduction Program has been a mainstay of Medicare’s hospital payment system since it began…