Remove 2026 Remove Fraud Remove Medicaid
article thumbnail

CMS proposes risk adjustment changes, broker fraud crackdown for 2026 plan year

Fierce Healthcare

A proposed rule from the Centers for Medicare & Medicaid Services (CMS) released Oct. | CMS is looking to shake up the risk adjustment model and wants the ability to suspend shady brokers from the insurance marketplace, the agency wrote among other updates in a new proposed rule.

Fraud 105
article thumbnail

Better Data Will Serve as the Foundation in Modernizing the Medicaid Program

CMS.gov

Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Administrator, Centers for Medicare & Medicaid Services. Medicaid & CHIP. Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Between 2013 and 2016, Federal spending on Medicaid grew by over $100 billion.

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

CMS Responds to Industry Stakeholder Feedback, Redesigns and Renames the GPDC Model for DCEs as the ACO REACH Model

Health Care Law Brief

On February 24, 2022, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), announced the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, which will begin January 1, 2023, and replace the Global and Professional Direct Contracting (GPDC) Model.

article thumbnail

CMS Announces Proposed Rule: Transforming Episode Accountability Model “TEAM”

Hall Render

On April 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) announced its plan to implement the Transforming Episode Accountability Model (“TEAM”), a new mandatory alternative payment model unveiled as part of the 2025 Hospital Inpatient Prospective Payment System proposed rule.

article thumbnail

Home Health PPS Final Rule for CY 2024: CMS Steps Back from the Brink

Hall Render

On November 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update Final Rule (“2024 Final Rule”), which has since been filed in the Federal Register. CMS proposed to change this to six months of inactivity.

article thumbnail

Health Provider News

Hall Render

celebrated by KidsABC for reaching key milestones Emory University and Emory St. celebrated by KidsABC for reaching key milestones Emory University and Emory St.

article thumbnail

Health Provider News

Hall Render

celebrated by KidsABC for reaching key milestones Emory University and Emory St. celebrated by KidsABC for reaching key milestones Emory University and Emory St.