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Citing a new report that found prescription drug spending reached $457 billion in 2015, the federal government announced it will test new Medicare Part B payment models to try to tackle those spiraling costs.
A recently released list of financial penalties imposed on Medicare Part C and Part D plan sponsors shows that the government is increasingly coming down hard on health plans that violate federal regulations.
Though the federal government has stepped back from its proposal to implement additional network adequacy regulations for Affordable Care Act plans, it will move forward with its initiative to provide Healthcare.gov shoppers with information about health plans' network breadth.
The now-finalized set of regulations for health plans that operate on the Affordable Care Act marketplace make good on the government's plan to create standardized exchange plan options despite some pushback from industry stakeholders.
Following criticism from the health insurance industry, the federal government has backed off portions of its proposed rule that would more strictly regulate health plans' network adequacy at the federal level.
A rushed, inadequate response to clear signs that Healthcare.gov was headed for trouble contributed to its ill-fated launch in 2013, according to a newly released, five-year study from the Office of Inspector General.
The Core Quality Measure Collaborative's unveiling of a standardized set of quality benchmarks represents a major milestone for a healthcare industry that too often struggles with burdensome reporting requirements. But the process to achieve this long-sought set of measures wasn't easy, nor is the work finished, Andrew Baskin, Aetna's national medical director for quality and provider performance measurement, tells FierceHealthPayer in an exclusive interview.
In addition to proposing changes aimed at improving the precision of payments to health plans, the federal government said it wants to raise Medicare Advantage payments by an average of 1.35 percent next year.
The Affordable Care Act's reinsurance program will pay out $7.7 billion for the 2015 benefit year, the Centers for Medicare & Medicaid Services has announced.
Though the Centers for Medicare & Medicaid Services has outlined how it will tighten the rules governing special enrollment periods, it also will add another SEP this year.
Press Releases
- AHIMA Launches Petition for National Voluntary Patient Safety Identifier
- HHS announces major commitments from healthcare industry to make electronic health records work better for patients and providers
- Statement by Theranos on CMS Audit Results
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- Majority of Americans Don't Use Digital Technology to Access their Doctors
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