Federal Court Nixes Affordable Care Act -- Confusion Grows, Congressional Leaders Vow Action, Courts Likely To Act A federal judge in Texas on Friday ruled that the Affordable Care Act is unconstitutional now that Congress has eliminated a penalty for those who forgo health insurance. U.S. District Judge...

Non-Profit Hospitals Will Struggle in 2019: Moody's & Fitch Not-for profit hospitals will continue their course in 2019 of having their expenses outpace their revenue streams, according to a Moody's Investors Service  report released last week. The outlook reflects Moody's expectation that operating cash flow in...

OIG Calls for Major Reforms to Medicare Wage Index System  According to a report released by the HHS Office of Inspector General last week, investigators discovered significant vulnerabilities in the wage index system while conducting reviews of hospitals’ wage data from 2004 through 2017.  The wage index, which is...

HHS Moves on Stark, Anti-Kickback Reforms; New Congress Wants More Health Care Changes Health care providers of all types are urging officials to waive or roll back the requirements of federal fraud and abuse laws so they can join forces and coordinate care, sharing cost reductions...

Bi-Partisan Senate Leaders Support Plan to Require Drug Prices in Ads The next Senate Finance Committee Chair Chuck Grassley (R-IA) and Minority Whip Dick Durbin (D-IL) sent a letter to HHS Secretary Alex Azar and CMS Administrator Seema Verma to support the Administration's proposal to require pharmaceutical...

56% of Hospitals Get "A" or "B" on New Leapfrog Safety Scorecard The independent, nonprofit grading system by the Leapfrog Group assigns “A,” “B,” “C,” “D” and “F” letter grades to general acute-care hospitals and focuses entirely on errors, accidents, injuries and infections. Of more than 2,600 hospitals...

CMS' Final Payment Rules Smack HOPDs, 340B, Postpone E/M Changes The Centers for Medicare and Medicaid Services late last week released two payment system rules that will have significant impact on payments to providers - the Hospital Outpatient Prospective Payment System the Medicare Physician Fee Schedule. Not...

President's Proposal to Cut Drug Prices Would Reduce Provider Payments President Trump has announced a proposal to lower drug prices by tying provider payments under Medicare Part B to the lower prices in Europe instead of the congressionally-mandated average sales price plus six percent. The notice...

HHS Rule Mandates Posting of Drug Prices; Could Be a Game-Changer Are consumers ready to see the price of their prescription drugs in TV ads?  How will they react?  HHS has released a proposed rule to require pharmaceutical manufacturers to disclose drug prices in their television ads....

Major Medicare Rule Changes: Update The 2019 Physician Fee Schedule is under review at the Office of Management and Budget and could be released in its final form as early as this week.  One of its key provisions is the collapse of Evaluation and Management...