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Medicare Proposes Higher Hospice Payments
The CMS intends increase Medicare payments to hospices and also make several tweaks to policy definitions and procedures to ensure more accurate reimbursement.
The CMS intends increase Medicare payments to hospices and also make several tweaks to policy definitions and procedures to ensure more accurate reimbursement.
The proposed payment rule would increase hospice payments by 1.3% for an estimated $230 million more than they received in fiscal 2014.
The rule also seeks to clarify the meaning of “terminally ill” in the hospice benefit. To be able to use the Medicare hospice benefit, a patient must be deemed to have a life expectancy of six months or less if the illness runs its normal course. While this has long been the standard, the CMS says the medical community has continued to express interest in a more nuanced definition.
As a result, the agency is seeking feedback on a definition that would take into account a person's physical, emotional, social and intellectual processes that collectively are causing progressive impairment of body systems.
Read the full story here: http://bit.ly/1ii76p8
Source: Modern Healthcare
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Neurologists Share Tips for Securing Patient Access to Gene Therapies
March 19th 2025Tenacious efforts at every level, from the individual clinician to the hospital to the state to Congress, will be needed to make sure patients can access life-saving gene therapies for neuromuscular diseases.
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The Impact of Cost Sharing on High-Value Care
March 14th 2025Michael Chernew, PhD, professor of health care policy and director of the Healthcare Markets and Regulation Lab, Harvard Medical School, shares how cost-sharing policies shape access to critical health care services and influence value-based insurance design.
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A Focus on MAHA, Lasting Changes to Health Care Programs for Trump’s Second Term
March 13th 2025The second Trump administration is expected to bring changes to Medicaid, Medicare Advantage, and the health insurance exchanges, as well as highlight the Make America Healthy Again (MAHA) movement, speakers at the Value-Based Insurance Design Summit said.
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