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...

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...

293 Hospitals Receive 5 Star Rating from CMS CMS has released its hospital rankings of more than 4,000 hospitals, of which 293 scored 5 out of 5 stars. The whole list documents: One star: 282 hospitals; Two stars: 800 hospitals; Three stars: 1,264 hospitals; Four stars:...

Senate Chairman Opens Investigation into Not-for-Profit Hospitals Senate Finance Committee Chairman, Sen. Chuck Grassley (R-IA), has re-opened an investigation into tax-exempt hospitals due to his concern that the hospitals aren't using billions of dollars in tax savings to prioritize community needs. Saying in a letter to the IRS...

Hospitals, Doctors, Insurers Mobilize To Kill Medicare for All Their message is simple: the Affordable Care Act is working reasonably well and should be improved, not repealed by Republicans or replaced by Democrats with a big new public program. More than 155 million Americans have employer-sponsored...