CMS expands authorized use of Medicare data

On July 1, 2016, the Centers for Medicare and Medicaid Services (CMS) issued final rules which expand authorized uses of Medicare claims data in order to improve health care quality and to control costs. The new rules allow CMS-approved “qualified entities” (QEs) to purchase Medicare claims data from CMS, to combine Medicare data with data from other payers, and to use such combined data to prepare multi-payer data analyses that QEs can provide or sell to authorized users. [More]

Federal Court of Appeals Panel strikes down 2014 CMS rule outlawing stand-alone fixed indemnity insurance policies for ACA purposes

On July 1, 2016, a Three-Judge Panel of the U.S. Court of Appeals for the District of Columbia Circuit overturned a 2014 final rule of the Centers for Medicare and Medicaid Services (CMS) that prevented individuals from having fixed indemnity insurance policies, which did not meet the “minimum essential insurance coverage” requirement of the Affordable Care Act (ACA). [More]

CMS proposes changes in Medicare home health programs

On June 27, 2016, the Centers for Medicare and Medicaid Services (CMS) proposed changes to the Medicare home health prospective payment system (HH-PPS), the home health quality reporting program (HH-QRP), and the home health value-based purchasing program (HH-VBP). The net effect of the proposed changes on home health agencies in 2017 would be to reduce aggregate Medicare payments on behalf of 3.4 million Medicare beneficiaries to 11,400 HHAs by about $180 million, about one percent of Medicare HHA expenditures. [More]