Keyword: Centers for Medicare & Medicaid Services (CMS)

HHS is appealing a New Mexico district judge's ruling that the agency's risk adjustment formula is "arbitrary and capricious."

Older physicians, males, and those with osteopathic degrees were more likely to be excluded from insurance due to fraud from 2007 to 2017.

Doctors may have heard a lot about MACRA, but not so much about new patient relationship categories and codes.

While many states now require Medicaid MCOs to address social determinants of health, federal law doesn't provide much flexibility to do so.

CMS has failed to recover more than half of the nearly $3 billion in Medicaid overpayments identified by auditors over an 11-year period.

Aurora Health Care will pay $12 million to settle allegations of federal kickback and false claims violations, plus more healthcare headlines.

ACOs have saved Medicare $2.7 billion, according to an analysis commissioned by NAACOS. CMS estimates pegged savings at $1.6 billion.

The Medical Group Management Association says the process to set electronic transaction standards between providers and health plans is "broken."

Kaiser Family Foundation is warning that CMS' changes to 1332 waivers could end up authorizing subsidies for non-ACA compliant plans.

Analysts cited new health spending data that shows flat growth in retail drug costs offset by higher physician-administered drug spending.