Uncategorized

Hospitals Improving Electronic Data Exchange

Hospitals are improving their interoperability and doing a better job of exchanging health data electronically, according to a review by the federal Office of the National Coordinator for Health Information Technology (ONC). According to a new ONC report, In 2021, more than 6 in 10 hospitals engaged in key aspects of electronically sharing health information (send, receive, query) and integrating of summary of care records into EHRs, a 51 percent increase since 2017. Availability and usage of electronic health information received from outside sources at the point of care significantly increased over the last four years, reaching 62 and 71 [...]

admin2023-01-31T06:00:22+00:00January 31, 2023|Uncategorized|

States Look to Take on Prior Authorization

The majority of states may act on insurer prior authorization practices in the coming year and even though the year is still only a month old, 16 states are already considering legislation to do so. The desire to act on prior authorization comes as providers continue to express dismay over delays in insurer review of the courses of treatment they seek to initiate for their patients, with some providers maintaining that those delays are jeopardizing the well-being of those patients. Insurers, meanwhile, insist that their reviews are necessary to ensure the health of their patients. In response to such expressed [...]

admin2023-01-30T06:00:53+00:00January 30, 2023|Uncategorized|

Health Insurance Markets Remain Highly Concentrated

The health insurance market was highly concentrated in 42 of the 50 states in 2019 and 2020 – the continuation of a trend identified in 2010 that has persisted ever since, according to a new report by the U.S. Government Accountability Office. The GAO considers a market concentrated if three or fewer insurers in a state have 80 percent of that market. Using Centers for Medicare & Medicaid Services health insurance enrollment data, the GAO looked at three distinct aspects of markets – individual policies, small group policies, and large group coverage – and found that Each of the three [...]

admin2022-11-10T06:00:51+00:00November 10, 2022|Affordable Care Act, Uncategorized|

Feds Taking the Long View on Monkeypox

Federal health officials are increasingly looking at monkeypox as a long-term challenge that may periodically create short-term crises. The number of monkeypox cases is not increasing exponentially and appears large confined to limited, defined communities and may eventually spread more like a sexually transmitted disease than a pandemic-style threat. In addition, as time passes more at-risk individuals are likely to receive vaccines to gain protection against the infection. Meanwhile, efforts continue to find more effective ways to treat the disease. Monkeypox has long been common in some countries and its presence in the U.S. suggests that it is likely to [...]

admin2022-10-17T06:00:49+00:00October 17, 2022|Uncategorized|

Feds Pursue Next Regs for Surprise Billing Law

In their continuing effort to implement the complex No Surprises Act, the 2020 law that seeks to prevent consumers from receiving surprise medical bills, federal regulators are now turning their attention to how providers and payers should inform insured individuals about the costs they may incur for procedures and purchases. Specifically, the federal agencies with jurisdiction over the law and its implementation – the Department of Health and Human Services, the federal Office of Personnel Management, the Internal Revenue Service, the Department of the Treasury, the Department of Labor, and the Employee Benefits Security Administration – have issued a request [...]

admin2022-09-22T13:00:58+00:00September 22, 2022|Uncategorized|

Hospital Financial Woes Continue and Will Persist

The immediate financial future for many hospitals is bleak, according to a new study. The study, by the health care management consulting company Kaufman Hall, concludes that “Margins remain depressed relative to pre-pandemic levels.” “More than half of hospitals are projected to have negative margins through 2022.” “Expenses are significantly elevated from pre-pandemic levels.” “Hospitals have faced a profound financial toll.” “Ultimately, U.S. hospitals are likely to face billions of dollars in losses in 2022 under both optimistic and pessimistic." The study cites the COVID-19 pandemic and inflation among the leading causes of hospitals’ financial distress. Learn more from the [...]

admin2022-09-21T06:00:06+00:00September 21, 2022|Uncategorized|

DeBrunner Partner Recognized by Publication

City and State Pennsylvania has named DeBrunner & Associates’ Michael Chirieleison one of its “2022 Health Care Power 100.” Since taking over the reins of DeBrunner & Associates’ Pennsylvania health care consulting, government relations, and advocacy practice, Mike has pushed the firm in new directions. From a mostly hospital-oriented practice, Mike and his team of policy, data, and lobbying professionals have moved boldly into biopharmaceuticals, long-term care, substance use services, and more. In recent years the firm has scored a number of successes, including the successful pursuit of legislation to increase state funding for skilled nursing facilities that care for [...]

admin2022-05-03T14:29:58+00:00May 3, 2022|Uncategorized|

Feds Plan for End of Aid for Certain COVID Services

As of March 22, 2022 at 11:59 p.m. (eastern) the HRSA COVID-19 Uninsured Program will stop accepting claims for testing and treatment due to lack of funds and on April 5, 2022 at 11:59 p.m. (eastern) the HRSA COVID-19 Uninsured Program and COVID-19 Coverage Assistance Fund will stop accepting vaccination claims due to a lack of funds. Today, the Department of Health and Human Services’ Health Resources and Services Administration (HRSA), which runs the Provider Relief Fund program, has provided additional information about this significant change in federal COVID policy with the publication of two new documents: HRSA COVID-19 Uninsured [...]

admin2022-03-17T16:03:40+00:00March 17, 2022|Uncategorized|

Surprise Billing Ban: Now the Hard Part Begins

Congress’s passage of a ban on surprise medical bills came after years of debate on the issue and was still somewhat of a surprise. But in hindsight, passing the ban may end up being the easy part. Now, federal officials need to develop regulations that will flesh out the ban, define terms, establish new processes, and more, and every indication is that this will be no less difficult than developing and passing legislation. According to Politico, lobbying on future regulations has already begun, with providers, consumer advocates, insurers, and even private equity interests vying to ensure that their needs are [...]

admin2021-05-03T06:00:45+00:00May 3, 2021|Uncategorized|

Health Care Reportedly Out of Biden American Families Plan

President Biden’s soon-to-be-introduced “American Families Plan” proposal apparently will not include a major health care component. The New York Times reports that The plan will not include an up to $700 billion effort to expand health coverage or reduce government spending on prescription drugs. Officials have decided to instead pursue health care as a separate initiative… Learn more about what is expected from the American Families Plan – and what is not expected – in the New York Times article “Biden Will Seek Tax Increase on Rich to Fund Child Care and Education.”

admin2021-04-26T13:00:22+00:00April 26, 2021|Uncategorized|