CMS finalizes prior authorization rule for DME

In a move meant to prevent fraud while protecting access to medically necessary supplies, the CMS issued a final rule that mandates prior authorization for some durable medical equipment prosthetics, orthotics and supplies, known

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ER Doctors Say Federal Rules Could Raise Patients’ Out-Of-Network Bills

Two professional organizations representing emergency doctors warn that a new federal rule could lead to higher out-of-pocket costs for consumers when they need emergency care outside their health plan’s network of providers.  But consumer

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Why the Fed’s rate hike could spur healthcare borrowing

The Federal Reserve announced a widely anticipated increase to the benchmark interest rate, the first in nearly a decade. The increase—a boost of 25 basis points, or 0.25 percentage points—may have little immediate cost to

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Sarbanes Refloats Primary Care Physician Reentry Act

Congressman John Sarbanes (D-MD) has re-introduced the Primary Care Physician Reentry Act, which identifies and supports programs that retrain doctors to work as primary care providers in health centers serving veterans, local communities and

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Hospitals launch specialty pharmacies to curb drug costs

With specialty drug spending soaring 60% in the past five years, large health systems have jumped into the specialty pharmacy business to assert some control over those costs by dispensing the drugs to their

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Employed Physicians Add Revenue, Trim Profits

Hospitals with very high physician employment generate stronger revenue growth but are less profitable than peer institutions with fewer employed physicians, Moody’s Investors Service says. It’s pretty simple.  Physicians are very expensive to employ,” says

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MedPAC backs proposal to slash millions from Medicare Advantage plans

The Medicare Payment Advisory Commission on Thursday unanimously backed recommendations that would reduce Medicare Advantage plan reimbursement by at least $200 million. MedPAC supports having Congress pass legislation that allows the HHS secretary to eliminate

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Medicare Penalizes 758 Hospitals For Safety Incidents

The federal government is penalizing 758 hospitals with higher rates of patient safety incidents, and more than half of those places had also been fined last year, Medicare records released late Wednesday show. The fines

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Final piece of steel lifted at Oishei Children’s Hospital

As crane operators prepared to lift the final piece of structural steel into place atop the John R. Oishei Children’s Hospital of Buffalo, officials pointed to a small tree fixed to the beam. The tree,

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NFP Outlook ‘Stable’ for 2016, Say Moody’s

The nation’s not-for-profit healthcare sector will likely see diminished cash flow and patient volumes in 2016, although the overall outlook in the sector for the next 12 to 18 months is “stable,” Moody’s Investors

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