Government: Page 147
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CareSource will cover final county without an ACA option in 2018
All U.S. counties are now expected to have at least one ACA plan option.
By Les Masterson • Aug. 24, 2017 -
Deep Dive
Clampdown on network directories fueling online solutions
"It’s problematic for both sides,” MGMA’s Robert Tennant says about the effort to keep health plan network directories updated.
By Meg Bryant • Aug. 24, 2017 -
Intermountain plans to cut opioid prescriptions by 40%
The company said it has already trained 2,500 prescribers in strategies to reduce opioid use, and is currently focusing on cases of acute pain.
By Shannon Muchmore • Aug. 24, 2017 -
CliniComp sues VA over Cerner EHR contract
CliniComp said the VA should have used the competitive bidding process for the EHR contract, but the agency said at the time it needed to forego bidding to expedite the new EHR.
By Les Masterson • Aug. 24, 2017 -
Deep Dive
Hospitals brace for more uncompensated care, lower reimbursements
Talk of major Medicaid cuts and a new way to calculate uncompensated care payments has hospitals worried about the financial downsides.
By Les Masterson • Aug. 23, 2017 -
Advisory panel pushes back on proposed 340B cost increase
Hospitals have lobbied extensively against the proposal, which would pay hospitals 22.5% less than the average sales price for drugs acquired through the program, instead of the current rate of 6% more than the average sales price.
By Shannon Muchmore • Aug. 23, 2017 -
BlueCross BlueShield of NC dropping grandfathered health plans
The move will affect about 50,000 members, who will be shifted to plans on the state's ACA exchange.
By Les Masterson • Aug. 22, 2017 -
Provider groups mostly approve of latest MACRA proposals
The proposed rule in question exempts more small providers from the Merit-Based Incentive Payment System, allows hospital-based physicians to report at a facility level and introduces virtual reporting groups.
By Shannon Muchmore • Aug. 22, 2017 -
Iowa, Oklahoma seek to create reinsurance programs with ACA waivers
With HHS promoting state innovation, more and more states are asking to waive certain ACA provisions and try their own programs.
By Les Masterson • Aug. 21, 2017 -
HHS proposes another 340B penalty rule delay
Implementation of the rule has already been delayed several times, and HHS is now proposing a start date in July 2018.
By Shannon Muchmore • Aug. 21, 2017 -
UMass Memorial drops out of Medicaid ACO program
The central Massachusetts health system will not be joining 17 other organizations participating in the state's Medicaid overhaul.
By Les Masterson • Aug. 21, 2017 -
AHRQ plans broad review of mobile diabetes management tools
At the current rate, one in three U.S. adults will have diabetes by 2050, according to the Centers for Disease Control and Prevention.
By Meg Bryant • Aug. 17, 2017 -
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CMS will start more targeted approach to Medicare fraud auditing
Medicare Administrative Contractors will be instructed to focus on providers with high claim error rates or unusual billing practices when compared to similar providers.
By Shannon Muchmore • Aug. 17, 2017 -
CMS launches Hospice Compare site
The site allows people to compare hospice providers based on certain quality metrics, such as the percentage of patients who were screened for pain or difficult or uncomfortable breathing, or whether patients’ preferences are being met.
By Les Masterson • Aug. 16, 2017 -
IRS revokes hospital nonprofit status for the first time
The agency reportedly stripped an unidentified hospital of its status due to failure to comply with 501(r) requirements.
By Jeff Byers • Aug. 16, 2017 -
CMS proposes to cancel, pare back bundled payment models
A proposed rule would cancel two cardiac programs and reduce mandatory participation for the joint model.
By Shannon Muchmore • Aug. 16, 2017 -
DC hospital curtails obstetrics services amid safety concerns
United Medical Center officials reportedly refused to discuss the issue, citing patient privacy concerns.
By Meg Bryant • Aug. 16, 2017 -
Primary care clinician shortage expected in California by 2030
The report predicted nearly half of the state’s full-time equivalent primary care clinicians will be nurse practitioners and physician assistants by 2030.
By Les Masterson • Aug. 16, 2017 -
CMS threatens to end NH Medicaid expansion funding
New Hampshire has until the end of fiscal 2018 to change the way the state funds its portion of Medicaid expansion.
By Les Masterson • Aug. 15, 2017 -
Survey: Most Americans not comparing prices for healthcare
Though out-of-pocket healthcare costs have skyrocketed, few Americans are searching for the data on those costs before getting care.
By Les Masterson • Aug. 15, 2017 -
CBO: With no CSRs, premiums increase 20%
A report predicts ending the payments would also mean a $194 billion increase to the federal deficit in the next 10 years, largely because of increased subsidies the higher premiums would require.
By Shannon Muchmore • Aug. 15, 2017 -
Deep Dive
Why ACA market upheaval still looms large despite failure to repeal the law
Whether lawmakers are done with efforts to repeal the ACA or not, some important changes for healthcare could be on the horizon.
By Shannon Muchmore • Aug. 14, 2017 -
Bundled payment proposals include canceled, scaled-back programs
The proposal reduces the number of mandatory geographic areas for the joint bundled payment program and cancels the cardiac bundled payment program model.
By Shannon Muchmore • Aug. 14, 2017 -
Trump says he will declare opioid crisis a national emergency
Details have not been released, but the order would likely free up funding for fighting the epidemic and give relevant federal and state agencies more leeway and resources.
By Shannon Muchmore • Aug. 11, 2017 -
Uncertainty influences early premium rate filings for ACA exchange plans
The CMS announced on Thursday it is extending the deadline for insurers to file their rates to Sept. 5. Payers no longer have to decide next week.
By Shannon Muchmore • Aug. 10, 2017
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