CMS
121-140 of 414 results
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Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients
Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and then predicts what kind of care an individual will need and for how long. New federal rules will ensure human experts are part of the process.
By Susan Jaffe -
These Appalachia Hospitals Made Big Promises to Gain a Monopoly. They鈥檙e Failing to Deliver.
Ballad Health, the only hospital system across a large swath of Tennessee and Virginia, has fallen short of quality-of-care and charity care obligations 鈥 even as it鈥檚 sued thousands of patients for unpaid bills.
By Brett Kelman and Samantha Liss -
Biden Administration Proposes New Standards to Boost Nursing Home Staffing
The proposal would require major hiring at the most sparsely staffed homes. But the proposal is already badly received by the nursing home industry, which claims it can鈥檛 boost wages enough to attract workers.
By Jordan Rau -
Exclusive: CMS Study Sabotages Efforts to Bolster Nursing Home Staffing, Advocates Say
Research commissioned by the Centers for Medicare & Medicaid Services analyzed only staffing levels below what experts have previously called ideal. Patient advocates have been pushing for more staff to improve care.
By Jordan Rau -
After Backlash, Feds Cancel Plan That Risked Limiting Breast Reconstruction Options
The Centers for Medicare & Medicaid Services backed off from a plan that could have curtailed access to a type of reconstructive surgery known as DIEP flap. Breast cancer patient advocates are relieved.
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Look Up Your Hospital: Is It Being Penalized by Medicare?
Each year, Medicare punishes hospitals that have high rates of readmissions and high rates of infections and patient injuries. Check out which hospitals have been penalized.
By Jordan Rau -
The Real Costs of the New Alzheimer鈥檚 Drug, Most of Which Will Fall to Taxpayers
The annual cost of lecanemab treatment quadruples if the expense of brain scans to monitor for bleeds and other associated care is factored in. The full financial toll likely puts it beyond reach for low-income seniors at risk of Alzheimer鈥檚, experts say.
By Arthur Allen Let鈥檚 Talk About the Weather
Episode 306It鈥檚 been the summer of broken weather records around the world 鈥 for heat, rain, and wildfire smoke 鈥 advertising the risks of climate change in a big way. But, apparently, it鈥檚 not enough to break the logjam in Washington over how to address the growing climate crisis. Meanwhile, in Texas, women who were unable to get care for pregnancy complications took their stories to court, and Congress gears up to 鈥 maybe 鈥 do something about prescription drug prices. Alice Miranda Ollstein of Politico, Shefali Luthra of The 19th, and Rachel Cohrs of Stat join Julie Rovner, 杨贵妃传媒視頻 Health News鈥 chief Washington correspondent, to discuss these issues and more. Also this week, Rovner interviews Meena Seshamani, the top administrator for the federal Medicare program.
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How a Medical Recoding May Limit Cancer Patients鈥 Options for Breast Reconstruction
The federal government鈥檚 arcane process for medical coding is influencing which reconstructive surgery options are available, creating anxiety for breast cancer patients.
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Doctor Shortages Distress Rural America, Where Few Residency Programs Exist
Patients in rural northeastern Nevada soon will have fewer providers and resources, after a local hospital decided to close its medical residency program. Nationally, the number of rural residency slots has grown during the past few years but still makes up just 2% of programs and residents nationwide.
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The Big Squeeze: More Enrollees and Smaller Networks Plague Some ACA Plans
Despite record enrollment in health insurance plans under the Affordable Care Act, some consumers who bought coverage and agents who helped them do so have had a tough start to the new year: Many say it鈥檚 hard to find an in-network doctor or hospital.
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A Progress Check on Hospital Price Transparency
Hospitals are facing mixed reviews regarding their efforts to comply with a federal requirement that they post information about prices related to nearly every health care service they provide.
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Congressman Seeks to Plug 鈥楽hocking Loophole鈥 Exposed by KHN Investigation
A federal lawmaker has introduced a House bill that would close one of a laundry list of oversight gaps revealed in a recent KHN investigation of the system regulators use to ban fraudsters from billing government health programs, including Medicare and Medicaid.
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Feds Move to Rein In Prior Authorization, a System That Harms and Frustrates Patients
The federal government wants to change the way health insurers use prior authorization 鈥 the requirement that patients get permission before undergoing treatment. Designed to prevent doctors from deploying expensive, ineffectual procedures, prior authorization has become a confusing maze that denies or delays care, burdens physicians with paperwork, and perpetuates racial disparities. New rules may not be enough to solve the problems.
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Struggling to Survive, the First Rural Hospitals Line Up for New Federal Lifeline
Hospitals in New Mexico, Texas, and Oklahoma are among the first to apply for a new rural hospital payment model that shifts the focus of services away from overnight stays to outpatient and emergency care. Still, experts say the law needs to be amended to provide the right mix of care for rural communities.
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Idaho Dropped Thousands From Medicaid in the Pandemic鈥檚 First Years
The removals, detailed in emails between state and federal health officials, hinged on disagreements over how states could disenroll people during the public health emergency. Consumer advocates fear the alleged violation signals the mess to come on April 1, when the pandemic-era Medicaid coverage mandate ends.
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Proposed Medicare Advantage Changes Cannot Accurately Be Called ‘Cuts,’ Experts Say
CMS advanced two proposed changes that could affect Medicare Advantage plans. One would allow the government to recover past overpayments. As a result, it could reduce those insurers鈥 profits, leading them to increase enrollees' out-of-pocket costs or reduce benefits. But it's inaccurate to characterize the changes as "cuts."
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As Pandemic-Era Medicaid Provisions Lapse, Millions Approach a Coverage Cliff
States are trying to reach millions of Medicaid enrollees to make sure those still eligible remain covered and help others find new health insurance.
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Nursing Home Owners Drained Cash During Pandemic While Residents Deteriorated
As the federal government debates whether to require higher staffing levels at nursing homes, financial records show owners routinely push profits to sister companies while residents are neglected. 鈥淎 dog would get better care than he did,鈥 one resident鈥檚 wife said.
By Jordan Rau