WEDI: HHS Should Create Office of National Cybersecurity Policy
The Working Group on Electronic Data Interchange (WEDI) says the Department of Health and Human Services (HHS) should create an Office of National Cybersecurity Policy led by a “cyber policy czar.” In the wake of the high-profile Change Healthcare and Ascension cyberattacks, WEDI sent a letter to HHS Secretary Xavier
Honoring Lyme Disease Awareness Month with a Multi-Year Plan to Change the Lyme Disease Status Quo
As part of Lyme Disease Awareness Month in May, the U.S. Department of Health and Human Services launched the Lyme Innovation Initiative and the LymeX Innovation Accelerator Multi-Year Plan to change the Lyme Disease status quo. Lyme. The multi-year plan includes five years of HHS Lyme innovation goals, impacts to
“Look, Ma, No Hands!” The Retail Clinic Thing Is Harder Than It Appears
In an indication of how challenging the primary care retail clinic landscape has become, Healthcare innovation Senior Contributing Editor David Raths reported on April 30 that after five years, Walmart Inc. “announced it will close 51 Walmart Health locations, as well as Walmart Health Virtual Care. The Arkansas-based retail giant
See my previous posts on negotiating IRA prices in drug selection (Part 1) and sending manufacturer data (Part 2). Today we will talk about the negotiation process and how CMS will set the maximum fair price (MFP) How will CMS be priced across all doses? “CMS will base the single
All of Us Research Program Funding Drops 34 Percent
The six-year-old All of Us research program faces a 34 percent decrease in 21st Century Cures Act funding for fiscal year 2024. The program is an effort to collect genomic and health data from 1 million or more people from widely diverse backgrounds for research purposes. Vanderbilt University Medical Center
Penn Medicine Creates New Role Overseeing Data and Technology Solutions
Penn Medicine in Philadelphia has created a new position of senior vice president of data and technology solutions that will oversee the offices of the chief information officer, chief medical information officer and chief analytics officer. Mitchell Schnall, M.D., Ph.D., was appointed to the new position, following two terms as
CMS launched Guidance on Negotiating IRA Prices last week. Below are some highlights on how medications will be selected. What medications are eligible for negotiation? For small molecules, drugs must (i) be approved by the FDA, (ii) be approved by the FDA at least 7 years ago, and (iii) not
House Bill Would Extend Telehealth, Hospital-at-Home Payments
The U.S. House Ways and Means Committee unanimously approved a bill that would expand Medicare patients’ access to telehealth services for two more years. The bill also includes a five-year extension of the acute hospital care home (AHCAH) waiver, which is set to expire at the end of this year.
What Significant Changes Will CMS Medicaid Managed Care Rule Bring?
The Centers for Medicare and Medicaid Services recently released a final rule that has broad implications for quality measurement and transparency in Medicaid managed care. Gary Jessee, senior vice president of national consulting at Sellers Dorsey, shared some insights with Healthcare innovation about the possible impact. Healthcare Innovation: Before we
Aledade Grows Michigan Footprint With Acquisition
Medical licensing company Aledade acquired Michigan-based Medical Advantage, which since 2014 has operated as a wholly owned subsidiary of The Doctors Company, the nation’s largest physician-owned medical malpractice insurer. The acquisition, for an undisclosed sum, expands Aledade’s medical association presence in Michigan from 35 to approximately 700. Aledade said it
Risk Adjustment and Incentives for Upcoding in Medicare – Healthcare Economist
To account for differences in disease burden among the patient population of Medicare Advantage (MA) plans, risk adjustment based on the patient’s disease burden is used. Specifically, MedPAC notes that: Medicare uses beneficiary characteristics, such as age and prior health conditions, and a risk adjustment model (the CMS Hierarchical Condition
CMS Medicaid Waiver Allows Massachusetts to Expand Coverage to Incarcerated
MassHealth, the Massachusetts Children’s Health Insurance and Medicaid Program (CHIP), received federal approval to modify its Section 1115 Demonstration. The 1115 Waiver, approved by the Centers for Medicare and Medicaid Services (CMS) through December 2027, allows Massachusetts to expand health insurance subsidies to people who would not otherwise be eligible
