President Calls on Congress To Fix Surprise Billing; Providers, Insurers Clash In a White House press conference last week, President Trump detailed key principles to tackle surprise medical bills and called on Congress to move legislation.  The Administration is looking to address situations where patients receive unexpected...

New CBO Report on Medicare-for-All Would Be Expensive, But No Price Tag Determined Both sides in the Medicare for All debate claimed victory with the Congressional Budget Report out last week that was thin on numbers but detailed on possibilities.  A change to single-payer, which a substantial...

Not-for-Profit Hospital Margins Positive in 2018: Moody's Following two-years of declines in profits, non-profit hospitals showed steady profitability in FY 2018, according to a Moody's Investor Service research announcement last week. The research shows that non-profit hospitals operating revenue growth increased to 5.1 percent in 2018,...

CMS' 2020 ACA Marketplace Rule Expects 70,000 Fewer Customers CMS has released the final payment and benefit rules for the ACA Marketplaces that included a number of changes geared to move people away from the exchange plans and to attempt to lower drug prices. The final rule...

MACPAC Unanimously Recommends Changes in Medicaid Definitions The advisory panel's June report to Congress will recommend that Congress clarify the statutory language that governs how to calculate the maximum amount of Medicaid DSH payments that can be disbursed to individual hospitals. The recommendation calls for excluding...

MedPAC Wants to Create National ED Coding Guidelines, Boost Payments for Rural Dialysis, Boost MA Data Accuracy  The Medicare Payment Advisory Commission has voted to approve a set of recommendations aimed at boosting the accuracy of Medicare Advantage encounter data. The recommendations included a broader set of...

Administration Seeks to Repeal ACA, Republican Leaders Back Away, Democrats Move Legislation To Strengthen It The Trump Administration has announced it would support a court ruling in the case of Texas v. Azar that declared the Affordable Care Act unconstitutional and should be scrapped. Meanwhile, House...

Battle Lines Forming Over Surprise Billing Battle lines are being drawn over a growing number of spruprise billing proposals now under discussion in Congress. Insurance and business groups sent a proposal to leaders in the House and Senate last week that would peg reimbursements to contracted market...

Vice President, Regulatory Policy David Introcaso, Ph.D., began his career in Washington at DC General Hospital in the mid-1990s.  Since then he has worked at NIH/NINR, at the Agency for Healthcare Research and Quality (AHRQ) as agency's Evaluation Officer, as a Public Health Analyst in the...

Providers Targeted with Hundreds of Billions of Cuts in Trump 2020 Budget President Trump has released his budget for fiscal year 2020 , which was declared "dead on arrival" by Congress and is seen as providing guidance for the appropriations process to come.  However, the budget...