Bulletin Board
Bulletin Board
Protecting Consumers AND Providers? No Surprise
As intended, the No Surprises Act is protecting consumers from unexpected medical bills. But it’s also protecting someone else: providers. In the three years since the No Surprises Act’s Independent Dispute Resolution process was implemented, providers have won about 85 percent of cases. In 2023 and 2024, that amounted to more than $2 billion in additional payments. One aspect of the No Surprises Act that has been a surprise is the frequency with which parties are resorting to it. Originally projected to settle about 17,000 disputes a year, the process [...]
Hospital Financial Progress in Jeopardy
While hospitals and health systems in general continue to move closer to their pre-pandemic level of financial performance, they now face challenges that threaten to undermine that progress. While they have slowly gotten their labor costs under control, providers now face rising non-labor costs, including for drugs and supplies. Meanwhile, two recent policies enacted by Congress may pose an even greater threat. New limits on Medicaid eligibility threaten to transform manageable losses from under-reimbursement for Medicaid services into uncompensated care at the same time that the elimination of enhanced Affordable [...]
Misinterpretation of Shutdown Plagues Telehealth
When federal authorization for Medicare-covered telehealth services lapsed at the end of the federal fiscal year on September 30, it was only supposed to affect traditional Medicare participants. But not everyone got the message. Some providers, confused about the lapse of Medicare authorization, are refusing to prescribe telehealth services for their non-Medicare patients. In addition, some health insurers are declining to cover telehealth services for their non-Medicare patients, misinterpreting the scope of the loss of Medicare authorization for telehealth care – something they should not be doing, according to a [...]
Federal Health Policy Update for October 9
The following is the latest health policy news from the federal government for October 3-9. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown. Congress and the Shutdown Today the Senate voted on separate Democratic- and Republican-led continuing resolutions (CRs) for the seventh time but again was unable to reach the 60-vote majority [...]
States Looking to Medicaid For Spending Cuts?
Amid growing budget pressures, a number of states have reduced Medicaid payments to providers – and others are looking to Medicaid as a possible source of savings. So far, Idaho and North Carolina have reduced Medicaid payments to providers while Illinois is looking at Medicaid, among other sources, in the face of its governor’s desire to reduce spending by four percent in the coming year. In addition, Indiana is pursuing a complex process of increasing state Medicaid payments to some providers through state directed payments but the net effect, according [...]