picture of sign that says "Danger Fraud Alert"

HHS OIG Hotline Scam – need to share & warn our partners asap

A telephone scam in which crooks alter caller ID to make it seem as if the call is coming from the HHS OIG Hotline 1-800-HHS-TIPS (1-800-447-8477) to get beneficiaries and members of the public to verify or share personal info which is used to victimize them via financial and other crimes – draining their bank accounts. OIG wants the public …

Do You Have the Facts About Medicare’s Financial Outlook for the Future?

Medicare is likely to be back on the federal policy agenda this year as Congress and President Trump pursue repealing and replacing the Affordable Care Act, and potentially consider options to reduce federal spending. When talking about Medicare, the nation’s federal health insurance program for 57 million people age 65 and over and younger people with disabilities, some policymakers often …

Nearly 12 million people with Medicare have saved over $26 billion on prescription drugs since 2010

Over 40 million Medicare beneficiaries utilized free preventive services in 2016 The Department of Health and Human Services released today new information that shows that millions of seniors and people with disabilities with Medicare continue to save on prescription drugs and see improved benefits in 2016 as a result of the Affordable Care Act. More than 11.8 million Medicare beneficiaries …

Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2017: Findings from a 50-State Survey

Jan 12, 2017 | Tricia Brooks, Karina Wagnerman, Samantha Artiga, Elizabeth Cornachione, and Petry Ubri Executive Summary Report Tables Endnotes This 15th annual 50-state survey provides data on Medicaid and Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal and cost sharing policies as of January 2017, and identifies changes in these policies in the past year. (See Appendix Tables 1-21 …

Medicare-Medicaid ACO Model joins growing number of state-based efforts to improve quality of care, lower costs

Today, the Centers for Medicare & Medicaid Services (CMS) announced the Medicare-Medicaid Accountable Care Organization (ACO) Model, a new initiative designed to improve the quality of care and lower costs for beneficiaries who are enrolled in both Medicare and Medicaid. The Medicare-Medicaid ACO Model builds on the current Medicare Shared Savings Program and advances efforts to partner with states in …

CMS blog – readmissions to hospitals

By Patrick Conway, M.D., principal deputy administrator and chief medical officer, CMS; and Tim Gronniger, deputy chief of staff, CMS The unfortunate experience of having to return to the hospital after recently being treated—or watching the same thing happen to a friend or family member—is all too common. Potentially avoidable hospital readmissions that occur within 30 days of a patient’s initial …

CMS proposes new standards to strengthen the Marketplace for 2018

CMS News FOR IMMEDIATE RELEASE August 29, 2016 Contact: CMS Media Relations (202) 690-6145 | CMS Media Inquiries The Centers for Medicare & Medicaid Services (CMS) today issued the proposed annual Notice of Benefit and Payment Parameters for 2018, which proposes additional steps to strengthen the Health Insurance Marketplace. CMS is issuing this rule earlier in the calendar year in …

Physicians and health care providers continue to improve quality of care, lower costs

CMS News FOR IMMEDIATE RELEASE August 25, 2016 Contact: CMS Media Relations (202) 690-6145 | CMS Media Inquiries Affordable Care Act Accountable Care Organization initiatives put patients at the center of their care while generating more than $1.29 billion in total Medicare savings since 2012 The Centers for Medicare & Medicaid Services (CMS) today announced the 2015 performance year results …

CMS examines inappropriate steering of people eligible for Medicare or Medicaid into Marketplace plans

Concerns raised about impact of 3rd party premium provider & affiliated organization payments The Centers for Medicare & Medicaid Services (CMS) today issued a request for information seeking public comment on concerns that some health care providers and provider-affiliated organizations may be steering people eligible for, or receiving, Medicare and/or Medicaid benefits into Affordable Care Act-compliant individual market plans, including …

DIAGNOSIS: UNPREPARED Elderly Hospital Patients Arrive Sick, Often Leave Disabled

By Anna Gorman Photos by Heidi de Marco August 9, 2016 SAN FRANCISCO — Janet Prochazka was active and outspoken, living by herself and working as a special education tutor. Then, in March, a bad fall landed her in the hospital. Doctors cared for her wounds and treated her pneumonia. But Prochazka, 75, didn’t sleep or eat well at Zuckerberg …