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States, Hospitals, Patients Brace for Big Beautiful Bill Effects

The effects of last year’s One Big Beautiful Bill Act will soon be felt by states, providers, and consumers and some of them are already preparing for the impact. States face an expected loss of $664 billion in Medicaid money over the next eight years as a result of 12 provisions in the 2025 law. The major causes: Medicaid work requirements that will reduce eligibility, more frequent eligibility redeterminations, and tougher limits on revenue-generating Medicaid provider taxes and Medicaid managed care state-directed payments. Some states will lose more than others. [...]

March 4, 2026|Categories: hospitals, Medicaid, Medicaid managed care, Medicaid regulations|Tags: Affordable Care Act enhanced premium subsidies, Hospital uncompensated care, Medicaid cuts, Medicaid eligibility redetermination, Medicaid managed care state directed payments, Medicaid provider taxes, Medicaid regulations, Medicaid reimbursement, Medicaid state directed payments, Medicaid work requirements, One Big Beautiful Bill Act|

MedPAC Posts Agenda for March 2-3 Meeting

The Medicare Payment Advisory Commission has posted the agenda for its next public meeting, which will be held on Monday, March 2 and Tuesday, March 3. The subjects scheduled for consideration during MedPAC’s next two-day session are: mandated report: Assessment of the Medicare ground ambulance data collection system access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease and beneficiaries with cancer provider participation in Medicare Advantage networks considerations for implementing Medicare Advantage encounter data in risk adjustment the complexity of Medicare enrollment decisions for beneficiaries [...]

February 27, 2026|Categories: Medicare, Medicare reimbursement policy|Tags: Medicare Advantage, Medicare and hospice care, Medicare and palliative care, Medicare enrollment decisions, Medicare Part B, Medicare Payment Advisory Commission, MedPAC|

Federal Health Policy Update for February 26

The following is the latest health policy news from the federal government for February 20-26. Some of the language used below is taken directly from government documents. Congress Both chambers of Congress are in session this week and next. The partial shutdown of the Department of Homeland Security that began on February 23 continues. The House Ways and Means Committee held a hearing titled “Advancing the Next Generation of America’s Health Care Workforce” to examine the shortage of resident physicians and explore ways to strengthen rural health care providers and Graduate Medical Education (GME). Watch the [...]

February 26, 2026|Categories: 340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|Tags: 340B, 340B Drug Pricing Program, 340B rebate model program request for information, DMEPOS waste fraud and abuse, health care waste fraud and abuse request for information, Innovation in Behavioral Health Model, intergovernmental transfers, Medicaid disproportionate share, Medicaid DSH, Medicaid section 1115 demonstration programs, Medicaid section 1915 demonstration programs, Medicaid state plan amendments, Medicaid waste fraud and abuse, Medicare and telehealth, Medicare App Library, Medicare Diabetes Prevention Program Expanded Model, Medicare Drug Price Negotiation Program public engagement events, Medicare Outpatient Observation Notice (MOON), Medicare Part D Premium Stabilization Demonstration, Medicare waste fraud and abuse, MLN Connects, Organ Procurement and Transplantation Network (OPTN), state-directed Medicaid managed care payments|

Groups Protest No Surprises Act Implementation

A group of more than 60 health care payers, employer groups, and others have written to the departments of Health and Human Services, Labor, and the Treasury to protest how the Independent Dispute Resolution process created under the No Surprises Act is deciding pay disputes between providers and insurers. The letter accuses payers of using the Independent Dispute Resolution process as a money-making tool. It also maintains that the panels deciding the disputes are favoring providers – which are winning 85 percent of the cases they consider – and are [...]

February 26, 2026|Categories: Uncategorized|Tags: Independent Dispute Resolution process, No Surprises Act, Surprise medical bills|

PRICE TRANSPARENCY NOT LIVING UP TO OBJECTIVE – YET

The requirement that hospitals post transparent information about their prices is not yet leading consumers to do more price shopping before obtaining care. Instead, to the degree that hospitals are fulfilling the requirement at all, the data they share is mostly used by other hospitals and insurers to aid in their negotiations with one another. Even when hospitals post the required data – many still do not – that data often is not presented in a way that is useful, or even comprehensible, for consumers. In addition, it can be [...]

February 25, 2026|Categories: hospitals|Tags: hospital price transparency|

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