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Cms Proposes Rule For 2018 Risk Adjustment Payments - Latest News


CMS proposes tweaks to 2019 Medicare Advantage risk-adjustment model

The proposed changes released last week are part of the 21st Century Cures Act passed in December 2016. That legislation required the CMS to improve the Medicare Advantage risk-adjustment ... old risk ... read more

Comments on CMS’s Proposed Rule, “Medicare Shared Savings Program; Accountable Care Organizations–Pathways to Success”

On August 17 th, 2018 ... if CMS is going to vary the rules that apply to ACOs based on their total Part A and B revenue, it should count revenue received by the broader set of providers. Modifying th... read more

Medicare Advantage Riding High As New Insurers Flock To Sell To Seniors

Bright Health, Clover Health and Devoted Health, all for-profit companies, began offering Medicare Advantage plans for 2018 or will ... to federal “risk-adjustment” payments. read more

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CMS Rule Strikes Obama-Era Regulation That Pays For Third-Party Fringe Benefits Instead Of Health Care

The Centers for Medicare and Medicaid Services released a proposed rule Tuesday that banned payments to third ... (RELATED: Trump Administration May Stop Risk-Adjustment Payments Under Obamacare) “The ... read more


ACP's initial review of QPP proposed rule 'encouraging'

The American College of Physicians (ACP) is encouraged that the 2018 proposed rule to implement the Quality Payment Program (QPP), released ... exemptions available for different groups. 5. Risk Adjus... read more

Will Insurers Suffer on Halt in Risk-Adjustment Payment?

On Saturday, the U.S. Centers for Medicare & Medicaid Services said that it will be compelled to suspend $10.7 billion in risk-adjustment payments which were due for ... The CBO estimates that this ru... read more

The Trump Administration Just Took a Sincere Step to Fix a Piece of Obamacare

and that there were many steps the feds could have taken short of stopping payments outright. One of the most obvious actions, they said, was issuing an interim rule, of the sort CMS produced this wee... read more

CMS restarts risk payments, will pay out $10 billion to insurers

The CMS issued a final rule Tuesday to resume paying $10.4 billion in risk-adjustment payments to insurance ... on its site that it had received a rule on the risk payments last week. HHS skipped the ... read more

Health insurance rates could rise with freeze on insurer payments

While bad news for the Blues, Priority Health stands to keep $57 million in payments it would have had to make to the Centers for Medicare and Medicaid Services ... If nothing changes and the risk-adj... read more

Trump administration freezes billions of dollars in payments to Obamacare insurers

The U.S. Centers for Medicare and Medicaid ... about their 2017 payments in June 2018, and then move the funds in the fall. The Trump administration could resolve the situation by issuing a new rule f... read more

It Sure Looks Like the Trump Administration Is Trying to Sabotage Obamacare Again

But in the meantime, the government says that, due to the court’s decision, it will no longer collect or distribute any more risk-adjustment payments ... 2018—which are the years at issue in the lawsu... read more

The Trump administration finds another way to throw sand in Obamacare's gears, at patients' expense

The latest example emerged over the weekend, when the Department of Health and Human Services announced it was suspending an ACA program known as risk-adjustment. At stake is $10.4 billion in payments ... read more



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