Washington State Adds Public Option Health Insurance

As “Medicare for All” becomes the mantra of several candidates for president, all progressive Democrats, Washington State on Monday inaugurated its own version of a public option health insurance plan, based on expanding the qualifications for Medicaid to 500 percent of the federal poverty line, or $62,450 a year for a single person. The agency […]

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Privately Insured Pay Twice What Medicare Pays Hospitals

A Rand Corp. study has found that people with private insurance — 156 million of them with health insurance from work — pay, on average, twice more for hospital care than what those on Medicare pay. The study is based on payment rates by private insurers in 25 states to 1,600 hospitals, and concludes that […]

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States Seek Medicaid Work Requirement Authority

The Centers for Medicare and Medicaid Services (CMS) is granting waivers for states to establish work requirements for the able-bodied who receive Medicaid health care services. The requirements usually consist of community service, job training or schooling, if not outright employment. The waivers are designed to control the costs of Medicaid expansion under the Affordable […]

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CMS Says It’s ‘Modernizing’ Medicare by Reducing Paperwork

Today, the Centers for Medicare & Medicaid Services (CMS) proposed what it is calling “historic changes” that would increase the amount of time that doctors and other clinicians can spend with their patients by reducing the burden of paperwork that clinicians face when billing Medicare. The proposed rules would fundamentally improve the nation’s healthcare system […]

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U.S. to Spend $685 Billion on Health Care Coverage for Those Under 65 in 2018

The federal government subsidizes health insurance for most Americans through a variety of programs and tax provisions. In 2018, net subsidies for non-institutionalized people under age 65 will total $685 billion, the Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) estimate. That amount includes the cost of preferential tax […]

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CMS Draws Line in Sand on Medicaid Caps

Seema Verna, administrator of the Centers for Medicare and Medicaid Services (CMS), today rejected a request by the state of Kansas to cap an individual’s Medicaid benefits at three years. In a letter to Kansas officials, Verna noted that only if Medicaid recipients refused to meet any work requirements would it be possible to cut […]

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CMS Seeks More Control Over Medicare Advantage Plans

The Centers for Medicare and Medicaid Services (CMS) is seeking public comment before it submits a proposal for more review power over Medicare Advantage plans in order “to provide adequate access to covered services to meet the needs of the population served.” The CMS says it will submit the broader review plan to the Office […]

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Private Insurers Pay Twice (or More) for Physician, Hospital Services than Medicare

At the same time that it issued its assessment of the Senate’s new health care plan, the Congressional Budget Office (CBO) released a related report comparing physician and hospital costs when paid by private insurers and when paid by Medicare and Medicare Advantage. The CBO found the average commercial payment rate for hospital admission was […]

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Hospital Quality Rating System Delayed by CMS

Is that hospital where you just had open-heart surgery a five star or a one star? You’ll have to wait until July, at the earliest, to find out. The Centers for Medicare and Medicaid Services (CMS) yesterday delayed implementation of its hospital quality rating system that was set to debut this week amid questions about […]

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CMS Seeks to Cut Medicare Drug Payments

The Centers for Medicare & Medicaid Services (CMS) has announced a proposed rule to test new models to improve how Medicare Part B pays for prescription drugs and supports physicians and other clinicians in delivering higher quality care. CMS values public input and comments as part of the rulemaking process, and looks forward to continuing […]

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