Bulletin Board
Bulletin Board
Federal Health Policy Update for March 26
The following is the latest health policy news from the federal government for March 20-26. Some of the language used below is taken directly from government documents. Congress Republican leadership is exploring a reconciliation bill as a potential vehicle to fund Immigrations and Customs Enforcement (ICE) and pass the Safeguard American Voter Eligibility Act (SAVE) voting rights act. If pursued, this approach could increase the likelihood of additional health care cuts, including expanding site-neutral payment policies in both Medicare and Medicaid. It is not clear whether there will be sufficient [...]
FTC Creates Health Care Task Force
A new group will join the fight to protect Americans from their country’s health care system. The Federal Trade Commission has announced the creation of a health care task force “…that will engage in a coordinated, integrated approach to healthcare enforcement and advocacy to protect American patients, healthcare workers, and taxpayers.” According to the FTC, the task force will: Lead targeted enforcement and advocacy initiatives focused on key priorities; Devise coordinated agencywide strategies on investigations; Take a proactive and strategic approach to identifying amicus and statement of interest opportunities; and [...]
CMS Takes an Axe to the Fax
The days of sending health care claims forms and claims-related documents by fax and regular U.S. mail are fast drawing to a close. Last week the Centers for Medicare & Medicaid Services announced that it will adopt a new regulation – “The Administrative Simplification; Adoption of Standards for Health Care Claims Attachments Transactions and Electronic Signatures Final Rule” – that will establish HIPAA-compliant standards for sharing health care claims attachments, enabling the secure electronic exchange of health care claims-related supporting clinical documentation and attachments such as medical records, x-rays and [...]
No Surprises Act Activity in 2025
A new Health Affairs report offers a preliminary look at No Surprises Act Independent Dispute Resolution activity for 2025. Among its findings: Providers and facilities initiated 99.9 percent of the disagreements submitted to the IDR process. Four provider groups or representatives of provider groups initiated more than half of those cases. Providers prevailed in 88 percent of the cases. Health plans challenged 40 percent of the cases submitted to the IDR process as ineligible for adjudication under that process. The IDRs upheld their challenges only 17 percent of the time. [...]
Looking Ahead to New Health Plan Price Transparency Requirements
If the new health plan price transparency requirements proposed by the Centers for Medicare & Medicaid Services are finalized later this year and implemented a year later, as anticipated, they will usher in significant changes in available data for use by consumers, providers, and businesses that collect, analyze, package, and sell such data. The anticipated changes in transparency requirements could include: Specific identification of rate changes from the most recently published rate. Reduced file sizes that eliminate some currently required data and a requirement that health plans post a single [...]