Bulletin Board
Bulletin Board
Federal Health Policy Update for Thursday, July 7
The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, July 7. Some of the language used below is taken directly from government documents. The Courts Hospitals may sue state Medicaid programs for failing to ensure that private insurers – such as Medicaid managed care plans – pay hospitals in a timely manner for the care they provide to their Medicaid patients, a federal appeals court has ruled. See the court’s decision in this case. Centers for Medicare & Medicaid Services CMS [...]
Hospital Readmissions Tied to Local Medical Resources?
Communities with more primary care doctors and more nursing home beds experience fewer avoidable hospital readmissions, according to a new study. At the same time, communities with more nurse practitioners and more home health agencies experience a high rate of hospital readmissions. In addition to the significance this may have for the welfare of the residents of individual communities, such a finding also may have implications for Medicare’s hospital readmissions reduction program, which penalizes hospitals that have “too many” readmissions for selected medical problems. If the availability of certain community [...]
Transparency Comes to Health Insurer Payments
When the calendar turned to July, health insurers came under a new federal requirement that they post on web sites the price they pay to every provider with which they contract for every service they cover. The mandate, which traces its origins to the Affordable Care Act and was introduced in a 2019 executive order, was designed to enable consumers to compare what different insurers pay different providers for different services and possibly help them shop for more affordable services for themselves. Doing so, however, will be a challenge for [...]
Federal Health Policy Update for Thursday, June 30
The following is the latest health policy news from the federal government as of 2:45 p.m. on Thursday, June 30. Some of the language used below is taken directly from government documents. White House The White House has unveiled its “White House Blueprint for Addressing the Maternal Health Crisis.” Monkeypox Update The White House has announced the first phase of its national monkeypox vaccine strategy, a part of its monkeypox outbreak response. The major components of the strategy include expanded efforts to vaccinate those most at risk, expanded testing supply [...]
Court Rejects Long-Running Medicare DSH Challenge
In a case that challenged a 2005 change in how the federal Centers for Medicare & Medicaid Services calculates Medicare disproportionate share (Medicare DSH) payments, the Supreme Court has, in a 5-4 decision, reversed a lower court ruling and upheld CMS’s policy of counting days of care for which Medicare does not pay in the Medicare fraction of the Medicare DSH percentage – a policy change widely viewed as disadvantageous to hospitals that care for larger numbers of low-income patients. This means that Medicare exhausted days and days of care [...]