Category: CMS

Nearly one-half million medical records have been submitted to Medicare auditors through the Electronic Submission of Medical Documentation (esMD) system since it launched in 2011. In its annual… read more …read more

Today’s headlines include a range of reports about state developments related to the health law’s online marketplaces as well as details regarding the latest Centers for Medicare & Medicaid Services’ figures on health costs. …read more

The Washington Post and Kaiser Health News report that some people who would be eligible for this coverage may be falling through the cracks. Meanwhile, Bloomberg examines how access to health care plays out differently in states that pursued the expansion and those that didn’t and a look at the difficult issue of people moving…

Shrinking revenues and rising costs could bring on the “death spiral” -; an unbalanced patient pool forcing huge premium increases (to restore revenue) that would further unbalance the patient pool as the young and healthy drop out. End result? Insolvency …read more

With Congress working on a long-term Medicare “SGR fix” in the recent short-term budget deal, lawmakers laid down seeds for addressing issues such as value-based reimbursement and EHR interoperability. read more …read more    

A new study of a 2008 expansion of Oregon’s Medicaid program showed those with new coverage used emergency rooms 40 percent more often than other adults, throwing some water on the long-held argument that expanding Medicaid coverage lowers ER usage and boosts primary care visits. …read more

For 60 years, Bobbie Jones, 88, had lived in the same Petworth rowhouse where she raised four children — including one born in an upstairs bedroom — and became a grandmother to 10 and a great-grandmother to nine. But last year, a stroke and a fall landed her in the hospital and then in a…

Today’s headlines include coverage of a new study examining how Oregon’s ER usage increased after expanding Medicaid. …read more

Because of Medicare’s huge scale, the prices it pays for procedures often shape what others pay for similar care, economist are finding. In the meantime, the program continues to look for ways to prevent inappropriate prescribing by its doctors. …read more

Protected health information of 1,918 Colorado Medicaid patients was compromised after a temporary employee from a private contractor, the Colorado Community Health Alliance (CCHA), sent the information to his or her own personal e-mail address, the Colorado Department of Healthcare Policy and Financing announced. Protected health information of 1,918 Colorado Medicaid patients was compromised after…