President-elect Donald Trump on Tuesday announced his appointment of Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services.
Read the full storyTrump Taps Dr. Oz to Lead Centers for Medicare and Medicaid Services
Tag: CMS
New Biden-Harris Medicare Pan Could Cost Taxpayers $20 Billion in Election-Year Giveaway, CBO Warns
In an election-year stunner, the Congressional Budget Office is warning the Biden-Harris administration’s new Medicare prescription drug plan could cost taxpayers more than $20 billion over three years.
The budget analysis arm of Congress said the increased costs are due to the government subsidizing many seniors’ premiums by sending money to insurance firms, and it would cost at least $5 billion extra in 2025 alone and add to the deficit.
Read the full storyTennessee U.S. Senator Marsha Blackburn Leads Push to Improve Access to Diagnostic Scans for Medicare Patients
Tennessee U.S. Senator Marsha Blackburn (R-TN) led a bipartisan group of 14 other senators in sending a letter to the U.S. Centers for Medicare and Medicaid Services (CMS) requesting that the agency work to increase patient access to Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) scans.
Read the full storyCommentary: The Left’s Misguided Attempt at a Drug Pricing ‘Fix’
Here in Tennessee, we stand up for what’s best for our communities and do what we can to encourage our elected officials to act in the best interests of our families and taxpayers. In health care, it often becomes convoluted and hard to decipher what will actually improve the lives of patients. When it comes to prescription drug affordability, prices continue to skyrocket and we need our lawmakers to do what they can to effectively lower costs and reject policies that will actually hurt patients and families.
Read the full storyPennsylvania Republicans Consider Paths to Hospital Price Transparency
A committee of GOP Pennsylvania lawmakers on Thursday gathered in downtown Lewisburg to consider ways to make patients aware of hospital service prices ahead of time.
At the House Republican Policy Committee hearing at the Open Discourse Coalition headquarters, policy experts testified that, despite a new federal rule requiring price transparency, many hospitals still fail to accurately inform patients of procedures’ costs. Representative David Rowe (R-Middleburg), who organized the event, recalled constituents telling him they’ve faced shocking examples of pricing opacity.
Read the full storyFlorida Will Not Enforce CMS Vaccine Mandate Upheld by SCOTUS
Earlier this week, the Supreme Court of the United States (SCOTUS) issued two decisions impacting vaccine mandates in the United States. SCOTUS issued a stay on the Biden Administration’s OSHA-based vaccine mandate for businesses with over 100 employees, striking a blow to Biden. However, the high court upheld the vaccine mandate put into place by the Centers for Medicare & Medicaid Services (CMS) for healthcare providers.
Read the full storyJudge Stops Federal COVID-19 Vaccine Mandate in Medicare, Medicaid Facilities in 10 States
U.S. District Judge Matthew T. Schelp on Monday ordered a preliminary injunction against the Biden Administration, stopping mandated COVID-19 vaccinations for health care workers in Centers for Medicare and Medicaid Services (CMS) facilities.
“Because it is evident CMS significantly understates the burden that its mandate would impose on the ability of healthcare facilities to provide proper care, and thus, save lives, the public has an interest in maintaining the ‘status quo’ while the merits of the case are determined,” Schelp wrote in a 32-page memorandum and order in the U.S. District Court in the Eastern District of Missouri.
Missouri Republican Attorney General Eric Schmitt led a 10-state coalition filing the lawsuit on Nov. 5 to stop the CMS vaccine mandate. On the courthouse steps in St. Louis, Schmitt, a candidate for the seat of retiring Republican U.S. Senator Roy Blunt, stated many will benefit from the ruling.
Read the full storyFeds Threaten to Remove Work Requirement from Georgia’s Partial Medicaid Expansion
The federal Centers for Medicare & Medicaid Services (CMS) could decide in a matter of weeks whether it will remove the work or activity requirement in Georgia’s partial Medicaid expansion plan.
The CMS said the plan, which was approved by former President Donald Trump’s administration in October, does not “promote the objectives of the Medicaid program” and would be impossible to accomplish because of the COVID-19 pandemic.
Read the full storyFederal Government Approves Tennessee’s Medicaid Proposal, Swapping a Block Grant for an Aggregate Cap
The federal government approved Tennessee’s proposed Medicaid aggregate cap, granting a lump sum for a self-imposed, fixed budget. The ten-year agreement, referred to as “TennCare III,” is the first of its kind nationwide. It also allows for the state to reserve any unused funds and apply them to other government programs, with up to 55 percent of those savings potentially matched by additional federal funds for state health programs.
The Centers for Medicare and Medicaid Services (CMS) described the measure as an “innovative financing approach.” Unlike what various reports claimed, federal officials explicitly stated that this agreement wasn’t a block grant. This agreement allows the state government to be flexible with its spending cap under certain circumstances – like last year’s pandemic and related unemployment crisis.
Read the full storyHouse TennCare Subcommittee Holds Summer Study on Controversial Medicaid Block Grant Proposal
The House TennCare Subcommittee took on the controversial topic of the block grant proposal, hearing from key stakeholders in a two-hour summer study conducted last Thursday.
Read the full storyTrump Administration Ends Unions ‘Skimming’ $100 Million a Year from Medicaid
by Bethany Blankley A final rule change has been implemented by the Trump administration to ensure that Medicaid providers receive complete payments as required by law. The Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (HHS) released the Medicaid Provider Reassignment Regulation final rule that removes states from being able to divert portions of Medicaid provider payments to third parties – including unions – outside of the scope of what the statute allows. The final rule came after CMS considered more than 7,000 comments from the public, healthcare providers, unions, state agencies, and advocacy groups during the public comment period after the changes were proposed. “State Medicaid programs are responsible for ensuring that taxpayer dollars are dedicated to providing healthcare services for low-income, vulnerable Americans and are not diverted in ways that do not comply with federal law,” CMS Administrator Seema Verma said in a statement. “This final rule is intended to ensure that providers receive their complete payment, and that any circumstance where a state redirects part of a provider’s payment is clearly allowed under the law.” Section 1902(a)(32) of the Social Security Act generally prohibits states from making payments for…
Read the full storyPresident Trump Moves to Protect Home Care Workers from Union Shakedown
By Richard McCarty The Centers for Medicare and Medicaid Services, a part of the U.S. Department of Health and Human Services, has proposed rolling back an Obama-Era regulation that allowed union dues to be deducted from Medicaid checks. If the proposed regulation takes effect, only deductions specifically allowed by law, such as court-ordered wage garnishments or child support payments, will be permissible. Of course, any caregivers who wish to join or stay in a union could still do so. They would just need to make arrangements to pay their dues, which could easily be done by authorizing the union to draft money from their bank account. For years, the Service Employees International Union (SEIU) has skimmed money off of Medicaid checks sent to in-home personal care workers. Many of these people care for relatives or friends and did not want to join a union. In Minnesota, 27,000 caregivers were unionized after an election in which fewer than 6,000 voted and SEIU received less than 3,600 votes. Unsurprisingly, some had no idea when the unionization election was being held and were surprised when they noticed that money had been deducted from their Medicaid checks without their authorization. Of course, SEIU does little for…
Read the full storyFormer GOP Congressional Candidate Dr. George Flinn: ‘Glad to Play a Small Role’ in Restoration of Medicare Billing Privileges to West Tennessee Doctor
Former Republican Congressional candidate Dr. George Flinn, who wrote President Trump asking him to instruct the Centers for Medicare and Medicaid (CMS) to amend the Obama-era regulation that were used against a beloved West Tennessee family physician, released a statement on Tuesday that he was “glad to play a small role in the restoration of Medicare billing privileges to Dr. Bryan Merrick, the family physician based in McKenzie, Tennessee: Congratulations to Dr. Merrick, his staff and the city of McKenzie. Ensuring that Dr. Merrick is able to continue serving his patients is an absolute victory, especially in a time when the patient-doctor relationship is dissolving due to government overreach and over regulation. Any help that was provided in writing a letter to President Trump, I was more than happy to do. I’m glad I was able to play a small role in doing the right thing and making sure patients continue to have access to Dr. Merrick. “Federal officials have restored Medicare billing privileges to Dr. Bryan Merrick, whose McKenzie Medical Center is located in the small West Tennessee city of McKenzie,” The Tennessee Star reported on Tuesday: The Tennessee Star led the way in reporting on the story of…
Read the full storyFederal Officials Restore Medicare Billing Privileges to Dr. Bryan Merrick in West Tennessee
Federal officials have restored Medicare billing privileges to Dr. Bryan Merrick, whose McKenzie Medical Center is located in the small West Tennessee city of McKenzie. The Tennessee Star led the way in reporting on the story of the well respected West Tennessee family practice doctor whose Medicare billing privileges were revoked in March under an Obama-era regulation over a reported $670 in billing errors. “Dr. Bryan Merrick has received word from federal officials that they are reversing an earlier decision to block Dr. Merrick from serving Medicare patients,” according to a statement released by the Office of Attorney Roy Herron on Tuesday, which can be read here: Dr. Merrick’s attorney, former state senator Roy Herron, was called on Monday by two of the several officials that Dr. Merrick and Herron had met with last Thursday in Baltimore. On the call the officials acknowledged to Herron how easily billing for the wrong one of two identically named persons could happen. The officials asked questions about actions taken by the McKenzie Medical Center to try to minimize clerical errors. After Herron explained those numerous preventive actions, the officials and Herron exchanged multiple emails. Late Monday, the officials confirmed that the Medicate revocation definitely would…
Read the full storyDr. Bryan Merrick Makes His Case To Top Federal Officials for Reinstatement into Medicare System
Dr. Bryan Merrick and his attorney Roy Herron met in Baltimore on Thursday with top federal officials at the Centers for Medicare and Medicaid Services (CMS), the part of the Department of Health and Human Services responsible for administering the Medicare program, to make the case for the reinstatement of his Medicare billing privileges. As The Tennessee Star reported, the well respected West Tennessee family practice doctor’s Medicare billing privileges were revoked in March under an abusive Obama-era regulation over a reported $670 in billing errors. Late last month, Senator Lamar Alexander (R-TN) called on Senator Orrin Hatch (R-UT) to hold hearings at the Senate Finance Committee he chairs to consider revoking the regulation. Earlier in October, McKenzie, Tennessee Mayor Jill Holland wrote a letter to Senator Alexander asking him to hold hearings of the Senate Health, Education, Labor, and Pensions Committee he chairs to consider revoking the regulation, but Alexander noted that Hatch’s Senate Finance Committee has jurisdiction over Medicare and Medicaid issues. Last week, former Congressional candidate Dr. George Flinn wrote President Trump a letter requesting that he instruct CMS to amend the regulation. “We had a good meeting. We felt like the officials listened carefully and asked…
Read the full storyMayor Asks Lamar Alexander to Hold Senate Hearings to Revoke Obama-Era Regulation That Permits CMS Abuse of Medicare Billing Cases
The mayor of McKenzie, Tennessee asked Senator Lamar Alexander (R-TN) to hold Senate hearings on the abuse of Medicare billing revocations by the Centers for Medicare and Medicaid Services [CMS] in a letter sent on Wednesday. Writing “on behalf of the citizens of Northwest Tennessee,” Mayor Jill Holland asked Alexander, “as Chairman of the Senate Health, Education, Labor, and Pensions Committee [to] schedule, at the earliest opportunity, a hearing of the appropriate subcommittee to consider the revocation or modification of a particularly egregious Obama-Era regulation promulgated by the Centers for Medicare and Medicaid Services (CMS) in December, 2014, “Medicare Program; Requirements for the Medicare Incentive Reward Program and Provider Enrollment; Final Rule.” “This regulation, and its abusive implementation by CMS, is now jeopardizing the health care of hundreds of eventually thousands of citizens in and around McKenzie, Tennessee, our city of 5,000 residents in Carroll, Henry, and Weakley counties,” Holland wrote. Holland then cites the case of Dr. Bryan Merrick, a beloved local family doctor who has practiced medicine in McKenzie for more than thirty years with an unblemished reputation. Merrick is the West Tennessee doctor who “lost his Medicare reimbursement privileges over $670 in billing errors, and the consequences…
Read the full storyTennessee Doctor Loses Medicare Reimbursement Privileges Over $670 in Billing Errors
A West Tennessee doctor has lost his Medicare reimbursement privileges over $670 in billing errors, and the consequences are devastating for his practice and the rural community he serves. “After an unblemished 31-year career in medicine a local doctor is faced with accusations of Medicare billing fraud. On April 16, the Center for Medicare and Medicaid Services (CMS) accused Dr. Bryan Merrick of 30 counts of wrongful Medicare billings over the course of 20 months,” the McKenzie Banner, located in rural Carroll County, reported last week: During the 20 month period in question, Dr. Merrick’s office filed approximately 30,000 Medicare claims for patients. The 30 claims account for less than one tenth of 1% of all billings. In other words, 99.9% of the 30,000 billings were filed correctly and in accordance with CMS guidelines. The estimated value of the wrongful billings is $670, which was never paid to Dr. Merrick or McKenzie Medical Center (MMC). All 30 counts are the result of clerical errors made by others, not Dr. Merrick directly. The penalty of these infractions is suspending Dr. Merrick’s Medicare billing privileges for at least three years. Meaning, he has a medical license and can see patients but no…
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