CMS Wants To Adjust Payments For Medicare Advantage Plans
Under the proposed changes, risk scores used to set payments would take into account certain diagnoses of mental health disorders, substance abuse disorders and chronic kidney disease. Meanwhile, the Department of Health and Human Services has finalized a rule that offers providers and payers more flexibility to share substance abuse patients' data.
Modern Healthcare:
CMS Proposes Tweaks To 2019 Medicare Advantage Risk-Adjustment Model
The CMS has proposed tweaking the way it pays Medicare Advantage health plans starting in 2019 by accounting for beneficiaries' mental health, substance abuse disorder and chronic kidney disease conditions in the risk-adjustment model. (Livingston, 1/2)
Modern Healthcare:
HHS Relaxes Rules On Sharing Substance Abuse Patients' Information
HHS has finalized a rule that aims to make it easier for insurers and providers to share substance abuse patients' data with other parties that are involved in providing and paying for that person's care. Under the current rules, insurance companies and providers would need to obtain consent forms from patients to share their information with every company involved in their care. That red tape sometimes slowed access to care or reimbursement. But HHS is looking to change that. (Dickson, 1/2)
In other Medicare news —
Georgia Health News:
Medicare Penalties For Patient Injuries To Hit Georgia Hospitals Hard
About one-third of eligible Georgia hospitals will see a reduction in Medicare payments in 2018 because of a high rate of patient injuries. The 35 percent penalized in Georgia is a higher percentage than all but five other states, a Kaiser Health News report reveals. (Miller, 1/1)