On February 6, 2024, CMS released an FAQ memo clarifying how a new Medicare rule (Final Rule) and the Affordable Care Act impact the use of AI and algorithms by MA organizations in making Medicare Advantage coverage determinations. The final rule (CMS Final Rule, CMS-4201-F) became applicable to coverage beginning January 1, 2024. The 2024 Medicare Advantage…
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March 14: A new CMS blog titled “Update on the Medicare Value-Based Care Strategy: Alignment, Growth, Equity” provides a progress report on accomplishments and a look toward the future for CMS’ Value-Based Care Strategy. It also covers CMS’ strategy to move toward value-based payment, a focus on alignment across payers, growth in accountable care, and promoting equity.…
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Biden-Harris Administration Announces New Initiative to Increase Investments in Person-Centered Primary Care ACO Primary Care Flex Model aims to improve access to high-quality primary care for underserved Medicare populations Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced a new voluntary model that empowers…
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At the height of the COVID-19 pandemic, when all 50 states and the federal government declared public health emergencies, telehealth became a lifeline for Americans. Now, to patients’ dismay, most states have rolled back telehealth access—disrupting care and putting lives at risk. Emergency telehealth waivers Telehealth, or telemedicine, allows patients to have virtual appointments with…
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Ransomware and hacking are the primary cyber-threats in health care. Over the past five years, there has been a 256% increase in large breaches reported to OCR involving hacking and a 264% increase in ransomware. In 2023, hacking accounted for 79% of the large breaches reported to OCR. The large breaches reported in 2023 affected…
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