hospital price transparency

Federal Health Policy Update for March 27

The following is the latest health policy news from the federal government for March 21-27. Some of the language used below is taken directly from government documents. Congress The House and Senate need to pass a joint budget resolution as a first step before committees can begin writing legislation to pass under reconciliation. Each chamber has passed its own budget resolution and while the two are very different, congressional leaders have agreed to write a less prescriptive resolution that will permit each chamber’s committees to determine the level of spending and saving required and then will try to work out [...]

joe2025-03-27T17:03:07-04:00March 27, 2025|Centers for Medicare & Medicaid Services, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for March 13

The following is the latest health policy news from the federal government for March 7-13. Some of the language used below is taken directly from government documents. Congress Funding the Federal Government Unless Congress passes spending legislation, funding for the federal government will expire at 12:01 a.m. this Saturday, March 15. This week, the House passed a continuing resolution that would fund the federal government through the end of the 2025 federal fiscal year. The bill extends telehealth flexibilities, the Acute Hospital Care at Home program, and other health extenders through September 30, 2025. The bill also delays cuts to [...]

joe2025-03-13T15:54:07-04:00March 13, 2025|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid long-term services and supports, Medicaid regulations, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for February 27

The following is the latest health policy news from the federal government for February 21-27. Some of the language used below is taken directly from government documents. Congress The current continuing resolution funding the federal government expires on March 14. Separately, a number of health care extenders, including preventing cuts to Medicaid disproportionate share (Medicaid DSH), an extension of telehealth flexibilities, an extension of the Acute Hospital Care at Home program, and other rural programs, will expire on March 31. Also, provisions that had been included in the bipartisan health care package proposed in December, including PBM reform, the package [...]

joe2025-02-27T16:26:33-05:00February 27, 2025|Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare reimbursement policy, social determinants of health|

Medicaid DSH Cut In, Medicare Site-Neutral Payments Out of Health Bill?

With Congress at a stalemate on spending legislation, lawmakers are considering a narrower scope of issues to address in near-term health care legislation. According to published reports, scheduled cuts in Medicaid disproportionate share allotments to states (Medicaid DSH), already delayed several times, could be delayed once again. In addition, a proposal to require Medicare to pay for outpatient services on a site-neutral basis, rather than paying higher rates to hospital-based outpatient departments higher rates, might not be included. Also under consideration: restoring some cuts in Medicare’s payments to physicians and additional funding for community health centers. Also in jeopardy at [...]

joe2024-02-27T18:53:55-05:00February 28, 2024|Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare cuts, Medicare reimbursement policy|

Federal Health Policy Update for May 25

The following is the latest health policy news from the federal government for May 19-25. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Committee has advanced to the full House two bills with significant implications for health care providers. H.R. 3561 calls for delaying $8 billion a year in Medicaid DSH cuts for two years – cuts scheduled to take effect in October; imposing site-neutral payments for drug infusion services provided in off-campus hospital outpatient departments; imposing stronger price transparency requirements on hospitals; and requiring hospitals to report selected ownership [...]

iqtsupport2023-05-25T15:37:35-04:00May 25, 2023|340b, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations, Telehealth|

Feds Getting Serious About Hospital Price Transparency

After warning many hospitals that they were not in compliance with a 2019 requirement that they post their prices on the internet, the Centers for Medicare & Medicaid Services has now fined two hospitals for failing to do so. Policy-makers and advocates have been warning for some time that too many hospitals were not complying with the requirement: a JAMA report found that within six to nine months of the requirement’s implementation only six percent of 5200 hospitals met the requirement and a later review conducted by patient advocates found only 14 percent of 1000 hospitals surveyed in compliance. Eventually [...]

iqtsupport2022-06-14T14:34:45-04:00June 14, 2022|Centers for Medicare & Medicaid Services|

Hospitals Starting to Comply With Price Transparency Requirement

One out of every three hospitals is in full compliance with a federal mandate to post payer rates publicly and transparently. And many others are partially in compliance with the federal requirement that took effect on January . Full compliance requires that the postings are machine-readable and include payer-negotiated rates for 300 “shoppable services.” 2000 of 6000 hospitals are already meeting four of five federal criteria and about 20 percent appear to be on their way to doing so. Hospitals began working to comply with the new federal mandate when their attempt to block it in court failed. Learn more [...]

iqtsupport2021-02-25T06:00:47-05:00February 25, 2021|hospitals|

Hospitals Advocate Losing Chargemaster

Hospitals would no longer need to post their chargemaster prices under a new approach to Medicare payments being advocated by a new hospital lobbying group. The small group, calling itself the Chargemaster Alternatives for Medicare Payment Alliance, wants Medicare to eliminate payment formulas based on chargemaster prices and base them instead on actual costs. Acting in response to a new proposal that hospitals be required to post their chargemaster prices, the group argues that chargemaster prices are irrelevant for all but a few consumers. Learn more about the group, its members, and its argument for ending use of chargemaster prices [...]

iqtsupport2019-10-28T06:00:54-04:00October 28, 2019|Medicare, Medicare reimbursement policy|