15+ hour, 40+ min ago  (740+ words) If finalized, the rule could impact multiple Children's Health Insurance Program (CHIP) and Medicaid programs and entities, plus other federal programs, before the end of 2027, including: In responding to the proposed rule, TMA told the Centers for Medicare & Medicaid Services…...

2+ mon, 2+ week ago  (357+ words) A former Aetna risk-adjustment coding auditor, suing on behalf of the federal government, alleged Aetna was paid an inflated monthly payment amount by the Centers for Medicare & Medicaid Services (CMS) as a result of the alleged upcoding. Under the terms…...

3+ mon, 3+ week ago  (624+ words) The budget bill signed into law on Feb. 3 includes changes to the Outpatient Prospective Payment System (OPPS), which the Centers for Medicare & Medicaid Services (CMS) uses to handle payment for hospital outpatient department services. Current TMA Board of Trustees Chair…...