CMS Chief Smacks Health Systems and Defends Site Neutral, 340B Payment Cuts CMS Administrator Seema Verma is making it clear where CMS stands on major issues impacting health systems. Late last week in a blog post she called out large hospital systems for anti-competitive behavior, and...

White House May Issue Sweeping Price Transparency Order  According to various reports, the White House is working on an Executive Order that will require complete price transparency for a broad range of providers and manufacturers across the health care industry. Rumors have been swirling for weeks that it...

Senate Committee Tackles Health Care Costs with Major Reform Bill The Senate Health Committee has released draft legislation that includes proposals on drug pricing, surprise billing, electronic health records and public health. The bill would set up an information exchange program for commercial insurers, strengthen incentives to improve cybersecurity practices, require...

Hospitals, Health Plans Targeted by Government in New Price Transparancy Push The Trump administration has been working behind the scenes for months on a strategy to force greater price disclosure across much of the $3.5 trillion health-care industry, according to a new report in the Wall...

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...