Government documents show that federal regulators rarely warn plans that their networks of health providers are so skimpy ...

A federal watchdog said Tuesday it has begun auditing nursing homes’ use of the Patient Driven Payment Model to drive skilled ...

On Oct. 31, CMS issued its final policy changes for Medicare payments under the Physician Fee Schedule, alongside other shifts in Medicare policy. The update comes after suspicion from ASC leaders ...

The Centers for Medicare & Medicaid Services (CMS) has issued preliminary guidance for states on how to implement new federal requirements on health care-related taxes in Medicaid ...

Split (or shared) visits—the current term used by the Center for Medicare & Medicaid Services (CMS)—allow non-physician practitioners (NPPs) and physicians who work for the same employer/entity to ...

Surveyed medical groups reveal burdens have increased in the past 12 months, resulting in delays or denials for necessary care. Despite scrutiny of prior authorization practices in Medicare Advantage ...

The US Centers for Medicare & Medicaid Services (CMS) finalized important changes to the Medicare provider and supplier enrollment regulations, including adding marriage and family therapists (MFTs) ...

CLEVELAND — The clock is ticking for Medicare beneficiaries. Open enrollment ends Dec. 7, and healthcare experts say many ...

While the AHA has called on CMS to rethink its plan to add prior authorization requirements to traditional Medicare, some argue that the program is due for some utilization management.

Medicare Advantage Special Needs Plans for chronic conditions offer additional healthcare coverage for people with severe or disabling conditions. A Chronic Condition Special Needs Plan (C-SNP) is a ...

According to the folks at Fidelity, a 65-year-old person retiring in 2025 can expect to spend $172,500, on average, on medical and healthcare expenses throughout their retirement. That doesn't even ...

A report from the Office of Inspector General claims Georgetown University Hospital in Washington, D.C., overbilled Medicare by roughly $659,400 primarily due to misunderstandings of billing ...