Bulletin Board
Bulletin Board
Looking Ahead to Lame Duck
When the dust clears after next week’s presidential election, Congress will return to Washington with numerous unfinished matters on its agenda – including many with implications for health care organizations. They include: Federal government funding, authorization for which expires on December 20. Medicare payments to physicians, which many in Congress want to increase if, as proposed, the Centers for Medicare & Medicaid Services reduces those payments for 2025. A potential temporary extension of the continued use of telehealth to prescribe Schedule 2 drugs such as Adderall. Payment adjustments for low-volume [...]
Insurers Skirting Medicare Two-Midnight Rule?
Health care payers continue to classify large numbers of Medicare admissions as “observation status,” and while the recent extension of the two-midnight rule to Medicare Advantage plans has resulted in a decline in the use of observation status classifications among those plans, Medicare Advantage plans still use the observation status classification more than three times as often as traditional Medicare. According to a new study, Medicare Advantage plans used the observation rate classification for between 14.4 percent and 16.1 percent of their claims during the first half of 2024. Traditional [...]
Federal Health Policy Update for October 24
The following is the latest health policy news from the federal government for October 18-24. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has issued new guidance outlining regulatory requirements for hospitals to report specific data on COVID-19, flu, and RSV. The new weekly electronic reporting requirements will apply to short-term acute-care hospitals, long-term-care hospitals, critical access hospitals, Indian Health Service hospitals, children’s hospitals, and cancer hospitals, with other types of hospitals – psychiatric hospitals and distinct part units [...]
Hospital Margins Expected to Remain Low Next Year
Labor costs that outstrip increases in reimbursements will lead hospitals to continue to have low operating margins through 2025, according to Moody’s, the bond and credit rating company. While the growth of hospital labor costs is no longer as great as it was during the COVID-19 pandemic, Moody’s reports, labor costs continue to grow – as do supply costs. Meanwhile, reimbursements are not keeping pace, with government payments especially lagging. As a result of these factors, hospital margins and operating cash flow margins are down and prospects for recovery in [...]
New Part D Limits on Target to Save Billions
By mid-2024, Medicare participants with Part D prescription drug plans had already saved nearly $1 billion in prescription drug costs as a result of a provision in the Inflation Reduction Act that capped Part D enrollees’ annual drug spending. For 2024 that limit is $3500 a year, and by the end of June nearly 1.5 million people had hit that limit and faced no more prescription drug costs for the rest of the year. 500,000 people hit that limit before mid-year and were already saving money – just shy of [...]