AHA urges Congress to reject reductions to the Medicaid program that would not only strip access to health care from some of ...

Lawmakers introduce bill to reverse Medicaid cuts and expand Medicare benefits, restoring eligibility and adding dental, vision, and hearing coverage.

Under a managed care arrangement, Medicaid MCOs determine the rates they pay providers for inpatient hospital services. States make capitated payments to Medicaid managed care plans for Medicaid ...

If you rely on Medicare, a significant change is on the horizon. The Centers for Medicare & Medicaid Services (CMS) recently announced the launch of a pilot program that will bring prior authorization ...

CMS is launching a pilot program aimed at lowering prescription drug costs in Medicaid by aligning prices with those paid in other developed countries. The program is set to begin in January. “CMS is ...

The primary goal for CMS must be to ensure that corrective actions are in place so that improper payments can be reduced, says GAO. What are the Centers for Medicare & Medicaid Services (CMS) doing to ...

A recent spate of Office of Inspector General audit reports calls into question some programs from the Centers for Medicare & Medicaid Services. It remains uncertain why the release of these audit ...

Indictment Issued for False Statements to CMS and Aggravated Identity Theft It was just a matter of time before the CMS EHR Incentive audit process uncovered alleged actions so severe that there was ...

ACOs entering MSSP with higher spending were consistently more likely to earn bonuses—a gap that persisted after a 2017 ...

The Directed Payment Program for Behavioral Health Services (DPP-BHS) is one of four directed payment programs (DPPs) HHSC submitted to the Centers for Medicare and Medicaid Services (CMS) for ...

The Texas Incentives for Physicians and Professional Services (TIPPS) program is one of four directed payment programs (DPPs) HHSC submitted to the Centers for Medicare and Medicaid Services (CMS) for ...