Co-Author: Nina Zhang, Stephenson Acquisto & Colman This article addresses the high-level challenges of tackling drug pricing policy related to prices that seniors and government programs pay, as well as the potential effects that the Trump administration’s policy efforts could have on those prices.1 Starting in January 2019, the Centers for Medicare & Medicaid Services … Continue reading this entry
Tags: CMS, Drug Pricing, Medicare Advantage, Part B, Part D, Trump
On April 2, 2018, CMS released the Contract Year 2019 Final Rules for Medicare Advantage (MA) and Part D (the MA Final Rule), incorporating changes that support CMS’ stated commitment to supporting flexibility and efficiency throughout the MA and Part D Programs.… Continue reading this entry
Tags: Centers for Medicare and Medicaid Services, CMS, Medicare Advantage, Medicare Advantage (MA), Part D
By now, providers are very familiar with Medicare recovery audit contractors, or RACs – the private companies who have authority to review medical records at a moment’s notice. For every dollar they opine has been improperly billed, the RACs recover a share of the bounty, creating a perverse incentive and an appeal process years behind … Continue reading this entry
Tags: Centers for Medicare & Medicaid Services, Medicare, Medicare Advantage, Recovery Audit Contractors (RAC), Risk Adjustment Data Valuation (RADV)
Posted in Reform