3 Federal Departments Endorse Site-Neutral Payment, Lifting Regulations

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The Departments of Health and Human Services, Labor, and Treasury endorsed site-neutral payment and lifting three regulations that limit competition in health care in a new report issued on December 3, 2018. The report, Reforming America’s Healthcare System through Choice and Competition, is in response to an executive order from President Donald Trump calling for […]

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Request for Information on Improving Outcomes for Medicare Beneficiaries with Social Risk Factors

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The Secretary of Health and Human Services (HHS), acting through the Assistant Secretary for Planning and Evaluation (ASPE), is evaluating the effect of individuals’ socioeconomic status on quality measures and measures of resource use under the Medicare program. The first product of this effort, a December 2016 Report to Congress: Social Risk Factors and Performance […]

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Reports: Medicare Advantage Plans Improperly Denying Claims

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— Anthem Adds Home Care Benefits Under Relaxed Medicare Advantage Rule Medicare Advantage plans are improperly denying medical insurance claims to patients and physicians, according to a report from the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) and a separate report in the New York Times. Roughly 20 […]

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Adam Boehler is the New Head of the CMMI

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Secretary of Health and Human Services Alex Azar has named Adam Boehler as the new director of the Center for Medicare and Medicaid Innovation (CMMI), as well as a deputy administrator at the Center for Medicare and Medicaid Services (CMS). Boehler, the former CEO of Landmark Health, has been rumored to be the Trump administration’s […]

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Omnibus Spending Bill Has New Money for HHS, Opioid Treatment

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The U.S. Senate and House of Representatives approved a $1.3 trillion omnibus spending bill that includes a $10 billion increase in funding for the Department of Health and Human Services and an additional $3.6 billion for treatment of opioid addiction and mental health services. Despite hinting at a veto, President Trump announced at a 1:00 […]

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OIG Reports on Vulnerability of Recertification Survey Lists

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A recent Department of Health and Human Resources  study by the Office of the Inspector General (OIG) found that home health agency-supplied patient lists were missing Medicare beneficiaries, allowing them to be excluded from surveyor reviews. The reviewers also found that surveyors were not able to comprehensively verify that HHA-supplied patient lists are complete at the time […]

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Administration Proposes Enhanced Religious, Moral Protections for Health Care Workers

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In mid-January, the Department of Health and Human Services (HHS) initiated efforts to better protect “conscience rights” of health care providers, which included the formation of a new Conscience and Religious Freedom Division in the HHS Office for Civil Rights (OCR).  This action was followed soon thereafter by issuance of a proposed rule–“Protecting Statutory Conscience […]

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HHS to Expand Medicare Settlement Conference Facilitation Program Starting April 2018

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–Program Applicable to Providers with Extensive Appeals in Pipeline The Department of Health and Human Services (HHS) has announced that the Office of Medicare Hearings and Appeals (OMHA) will expand its current Settlement Conference Facilitation (SCF) program to reach additional providers and suppliers in April 2018. The SCF is a dispute resolution process at OMHA […]

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Alex Azar Picked as New Secretary of HHS

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On Monday, President Donald Trump announced Alex Azar as his choice to be the next Secretary for Health and Human Services, following the resignation of former Rep. Tom Price (R-GA), who stepped down at the end of September amid complaints about his usage of chartered flights at taxpayer expense. Unlike Price, who spent 12  years […]

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