Senators Tackle Surprise Medical Bills; Medical Groups Caution Against Capping Payments Led by Sens. Bill Cassidy, M.D. (R-LA) and Michael Bennet (D-CO), a group of bipartisan Senators sent letters asking for detailed information from providers and insurers regarding surprise medical billing practices as they draft legislation to halt the...

Hospital-Acquired Conditions Down Significantly Good news for hospitals and their patients, according to the latest Agency for Healthcare Research and Quality's National Scorecard on Hospital-Acquired Conditions, HACs have dropped by about 13-percent over a three-year period. HACs include infections, adverse drug reactions, and similar unintended side effects. Of particular...

Large Hospital DSH Cuts Scheduled for October 1; MACPAC Says Congress Should Slow Them Down The Medicaid and CHIP Payment and Access Commission recommended that if Congress allows the disproportionate share hospital allotment cuts to move forward that they change the law to slow them down...

Partner Strategic Health Care - Ohio, North Carolina, Washington, D.C. Barbara Sears is a Partner in the national consultancy Strategic Health Care. Prior to joining firm, she served as the Director of the Ohio Department of Medicaid, Ohio’s first cabinet-level state Medicaid agency. The department became a cornerstone...

MedPAC Recommends Increases to Hospitals, LTCHs, No Increases for ASCs, SNFs, Reductions for IRFs, Home Health The Medicare Payment Advisory Commission last week recommended 2-percent payment increases to both short-term acute and long-term acute care hospitals in 2020. Additionally, the Commissioners voted to recommend to replace...

New Congress Tackling Drug Prices Two democrats and an independent introduced bills in the House and Senate to lower the high costs of drugs. Sen. Bernie Sander (I-VT), Rep. Elijah Cummings (D-MD), Rep. Ro Khanna (D-CA) introduced a three-part plan last week that included: The Prescription...

House Votes to Join Legal Defense of ACA; Committee Plans Hearing on Judge's Decision  In one of the first votes after taking over the House, Democrat leaders pushed through a measure to allow the chamber to defend the Affordable Care Act in court by joining the...

Happy New Year! Judge Rules in Favor of Hospitals in 340B Case In a major development, Federal D.C. district court Judge Rudolph Contreras sided with hospitals stating that CMS overstepped its authority when cutting 340B drug reimbursement by almost 30 percent as part of the 2018 hospital outpatient pay...

Senior House Democrats' New Bill Ramps Up the Medicare Expansion Debate Earlier this week, Congresswomen Rosa DeLauro (D-CT) and Jan Schakowsky (D-IL) introduced legislation, the Medicare for America Act, that would greatly expand Medicare coverage while maintaining employer-sponsored health insurance for those who have it and...

Credentialing and Contracting Consultant   Stephanie comes to Strategic Health care with over ten years of professional experience in the health insurance and billing industry. In 2008, she began as an Account Specialist for a physical therapy billing and collection group. She worked with the insurance plans...