Bulletin Board
Bulletin Board
Court Sides Again With Providers on No Surprises Act
A federal appellate court has affirmed a lower court ruling that the manner in which federal regulations tell No Surprises Act dispute arbiters to evaluate competing fee claims unfairly favors health care payers over providers. At issue is a regulatory directive that arbiters weigh what is known as the qualifying payment amount – the median of what insurers contract to pay providers in a given geographic area – when deciding on payments. In February a federal court ruled that using this measure in what is known as the independent dispute [...]
Federal Health Policy Update for August 8
The following is the latest health policy news from the federal government for August 3-8. Some of the language used below is taken directly from government documents. No Surprises Act A federal appeals court has upheld a February lower court ruling that found that the current No Surprises Act’s arbitration process for addressing payment disagreements between payers and providers favored payers by giving too much weight to “qualifying payment amounts,” which are the median of what insurers contract to pay providers in a given geographic area. Learn more from the [...]
Number of Uninsured on the Rise
The number of uninsured Americans has risen significantly over the past year: from 25 million in March of 2023 to 27 million in March of 2024, according to new data from the Centers for Disease Control and Prevention (CDC), with the uninsured rate rising from a record low of 7.7 percent to 8.2 percent. The rise in the number of uninsured people results primarily from individuals who became eligible for Medicaid during the COVID-19 public health emergency, a period during which states could not redetermine eligibility without losing some of [...]
Federal Health Policy Update for August 5
The following is the latest health policy news from the federal government for July 19 – August 5. Some of the language used below is taken directly from government documents. CMS – Medicare Payment Regulations Final FY 2025 Inpatient Prospective Payment System Regulation CMS has finalized its hospital inpatient prospective payment system rule for FY 2025. In the next fiscal year CMS will increase Medicare inpatient payments 2.9% while cutting Medicare disproportionate share hospital payments (Medicare DSH) $200 million. It also has: finalized its use of new core-based statistical area [...]
Federal Health Policy Update for July 18
The following is the latest health policy news from the federal government for July 13-18. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has issued a notice alerting certain clinicians who are qualifying alternative payment model (APM) participants and who have earned an APM incentive payment that the agency does not have the current contact information it needs to disburse their payments. The notice provides information to qualified participants on how to update their Medicare billing information so that [...]