Risk Adjustment Payment Program in the ACA Seems to Be Working
A recent analysis conducted by Oliver Wyman Actuarial and backed by the Blue Cross Blue Shield Association, found that overall,…
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DOJ Reaches $45 Million Settlement with Skilled Nursing Facilities Over…
The United States Department of Justice (DOJ) recently reached a $45.6 million settlement with six skilled nursing facilities…
North Carolina Reaches $1.45 Million Settlement with South Carolina Medical…
North Carolina Attorney General Josh Stein recently announced a $1.45 million settlement with South Carolina clinic Med First…
AMGA Opposes Disincentives for Health Care Providers that Commit…
AMGA recently sent a letter to the United States Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita…
California Company Reaches $6 Million False Claims Settlement with DOJ
Ultragenyx Pharmaceutical, a company based in California, recently agreed to pay $6 million to settle allegations that it caused…
CMS Issues Final Rule on 340B Program Underpayments
The Centers for Medicare & Medicaid Services (CMS) released a final rule in early November detailing how the agency will…
CMS Issues 2025 Notice of Benefit and Payment Parameters
Recently, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to offer changes to the Patient Protection…
21st Century Cures Proposed Rule on Information Blocking Published
Recently, the U.S. Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information…
CMS Publishes Revised Guidance on Part B and Part D Inflation Reduction Act…
On December 14, 2023, the Centers for Medicare & Medicaid Services (CMS) published two revised guidance documents implementing…
CMS Issues 2025 Proposed Changes for MA and Medicare Prescription Drug…
On November 6, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule regarding Contract Year 2025…