hospital price transparency

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+00:00February 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 [...]

admin2023-05-25T15:37:35+00:00May 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 [...]

admin2022-06-14T14:34:45+00:00June 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 [...]

admin2021-02-25T06:00:47+00:00February 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 [...]

admin2019-10-28T06:00:54+00:00October 28, 2019|Medicare, Medicare reimbursement policy|