CMS

iSTock

The state expects to turn over management of the care of medically fragile children to a subsidiary of WellCare Health Plans beginning in January. 

Appeals Court Backs Dismissal Of CMS Challenge

Dec 28, 2017
Department of Children and Families

A divided appeals court Wednesday sided with the Florida Department of Health in a dispute about the repeal of a regulation in the Children's Medical Services program.

What’s At Risk In GOP’s Health Overhaul

Feb 21, 2017
WMFE

As Republicans look at ways to replace or repair the health law, many suggest shrinking the list of services insurers are required to offer in individual and small group plans would reduce costs and increase flexibility.

CMS Identifies Hospitals Paid Nearly $1.5B In 2015 Medicare Billing Settlement

Aug 23, 2016

A year after paying nearly $1.5 billion to more than a third of U.S. hospitals to resolve longstanding Medicare billing disputes, the Obama administration has disclosed who got paid.

Study Suggests Federal Standard May Be Thwarting Some Transplant Patients

Jun 7, 2016

For the roughly 15,000 people who need a liver transplant, it’s a waiting game. With demand for donated livers far outstripping supply, patients may spend months or years on a transplant waitlist, their position in the line gradually improving as they get sicker. A recent study suggests that this system may be changing but not necessarily for the better.

Bowing to pressure from the hospital industry and Congress, the Obama administration on Wednesday delayed releasing its new hospital quality rating measure just a day before its planned launch.

Associated Press

For most hospitals in Florida, Medicare is changing the way it pays for hip- and knee-replacement operations to ensure that patients get the right care at the right time at the right price for taxpayers. 

Cigna Profits As Medicare Softens Penalty Policy

Mar 14, 2016
Associated Press

Cigna will get to keep hundreds of millions of dollars in bonus payments for some of its Medicare Advantage plans, despite recently-imposed sanctions for mismanaging those plans in ways that federal officials said threatened seniors’ health and safety.

Florida Department of Health

Attorneys representing four children with serious heart conditions have challenged a move by the Florida Department of Health to repeal cardiac-care standards related to a program that provides specialized services to children.

Senate Panel Wants Answers From DOH On Children's Health Programs

Oct 8, 2015

A Florida Senate panel on Wednesday demanded answers from a state Department of Health official about how many special-needs children have recently lost services as the state transitions to a new Medicaid system --- and why.

GAO: More Oversight Needed Over Medicare Advantage

Oct 1, 2015
General Accountability Office

The federal government needs to increase its oversight over private Medicare health plans to make sure seniors have adequate access to doctors and hospitals, according to a report released this week by congressional auditors.

FL Shines in Home Health Star Ratings

Jul 21, 2015
Census.Gov

The federal government released a new five-star rating system for home health agencies, hoping to bring clarity to a fast-growing but fragmented corner of the medical industry where it’s often difficult to distinguish good from bad.

Children's Medical Network Challenged

Jun 29, 2015
Florida Department of Health

The families of four Florida children with special health-care needs have filed a challenge to a new state process that removed them from a program providing services to medically fragile kids.

On Thursday, attorneys for the families filed an administrative challenge to the Florida Department of Health's process, contending that the agency has been screening youngsters out of the Children's Medical Services Network without accepting public input or following other rule-making requirements.

Georgetown University Health Policy Institute

A plan to provide health care coverage to 800,000 Floridians faces an uphill battle after unanimous approval by the Senate Health Policy Committee.

U.S. Health Spending Growth Lowest Since 1960

Dec 4, 2014

National health spending grew 3.6 percent in 2013, the lowest annual increase since the Centers for Medicare and Medicaid Services (CMS) began tracking the statistic in 1960, officials said Wednesday.

Spending slowed for private health insurance, Medicare, hospitals, physicians and clinical services and out-of-pocket spending by consumers.  However, it accelerated for Medicaid and for prescription drugs, according to the report, published online by the journal Health Affairs.

Former Orlando Health patients may have to help repay the Centers for Medicare and Medicaid Services after a federal audit discovered the hospital overbilled Medicare by $1.45 million, the Orlando Sentinel reports.

Medicare Won't Pursue Overpayments

Jun 2, 2014

Medicare spent $6.7 billion too much for office visits and other patient evaluations in 2010, according to a new report from the inspector general of the U.S. Department of Health and Human Services.

But in its reply to the findings, the Centers for Medicare and Medicaid Services (CMS), which runs Medicare, said it doesn't plan to review the billings of doctors who almost always charge for the most expensive visits because it isn't cost effective to do so.

U.S. Sen. Bill Nelson cranked up the hopes of many Democrats last week by hinting that he had a plan that might revive the moribund Medicaid expansion in Florida, which would cover those too poor to qualify for tax credits on Healthcare.gov.

Federal agencies are teaming up to improve oversight of nursing homes, a practice that now misses a third of the cases of substandard care, according to Kaiser Health News.

Is FL a Risk to Healthcare.gov?

Feb 26, 2014
The Associated Press

Security experts working for the federal government last fall said two-thirds of state computer systems that were supposed to tap into federal computers to verify personal information for coverage were rated as "high risk" for security problems, the Associated Press reports.

According to a map from the House Committee on Oversight and Government Reform, Florida was one of the states the security experts identified as having a risky connection point.

The federal government says no more people can enroll in Caremark's SilverScript Medicare prescription plan. The suspension order from CMS comes after a system failure prevented thousands from getting their medicine.

In a week or two, seniors enrolled in certain Medicare health plans and drug plans will get a letter from the federal government. It is not good news.

The Centers for Medicare and Medicaid Services (CMS) letter will say their plan is substandard, "rated 'poor' or 'below average' for at least the last three years."