Government: Page 78
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CMS pushes back payer MLR reporting deadline, citing COVID-19
The agency said granting flexibility would help insurers pay rebates mandated by the Affordable Care Act more quickly to enrollees, but issued no requirement that they be sped up.
By Ron Shinkman • June 15, 2020 -
Air ambulance market is 'dysfunctional,' puts most patients at risk for huge surprise bills: analysis
Even the insured struggle to pay, with median charge for in-network claims up from $24,938 in 2014 to $32,708 in 2017, according to claims data from Aetna, Humana and UnitedHealthcare.
By Ron Shinkman • June 12, 2020 -
Trendline
Labor
Hospitals are navigating persistent labor shortages with the need to cut costs — a source of contention that could leave patients caught in the middle.
By Healthcare Dive staff -
"Official U.S. Navy PageFollow Sailor screens a patient in their car at Naval Medical Center Portsmouth’s COVID-19 drive thru screening" by Official U.S. Navy Page is licensed under CC BY 2.0
OpinionIt's time for a national hospital supply chain czar
If the current lack of supply chain coordination isn't resolved before the expected second surge in COVID-19 cases strikes, the result will be a far worse crisis, writes Jody Hatcher, a healthcare supply chain expert.
By Jody Hatcher • June 12, 2020 -
Pennsylvania mandates more COVID-19 protections for hospital workers
The new rules focus on effective contact tracing that is labor intensive, Gerald Maloney, chief medical officer for Geisinger Health, which operates six hospitals in the state, told Healthcare Dive.
By Hailey Mensik • June 11, 2020 -
COVID-19 fuels major unknowns as insurers tackle 2021 rate setting
An American Academy of Actuaries brief laid out challenges that may boost costs, including a shift in coverage leading to adverse selection, deteriorating health for those delaying care and pressure on reimbursement rates.
By Samantha Liss • June 11, 2020 -
Master Sgt. Hecht, Matt. (2020). [Photograph]. Retrieved from Flickr.
COVID-19 testing costs may hit $25B per year, AHIP study finds
The low estimate for diagnostic testing is $6 billion, while antibody testing costs could range from $5.2 billion to $19.1 billion, according to the report paid for by the payer trade group.
By Shannon Muchmore • June 10, 2020 -
Master Sgt. Hecht, Matt. (2020). [Photograph]. Retrieved from Flickr.
Trump administration suggests restarting electives, with reliance on telemedicine, safety measures
Major surgeries should still be limited as much as clinically possible, and facilities should be prepared to screen all visitors and staff for symptoms as well as provide masks for those who don't have one.
By Shannon Muchmore • June 9, 2020 -
After criticism, HHS directs $25B in CARES funding to Medicaid providers, safety net hospitals
About 750 safety net hospitals will receive funding. The administration noted that many of these hospitals are operating in the red with an average profit margin of -7%.
By Samantha Liss • June 9, 2020 -
HHS resolves complaint over COVID-19 no-visitor policy for patients with disabilities
In May, the agency began receiving complaints that Connecticut's guidance violated the Americans with Disabilities Act, alleging that without support people, patients with disabilities were denied equal access to treatment.
By Hailey Mensik • June 9, 2020 -
To revamp 'antiquated' EHR system, VA needs more specialty docs involved, GAO says
The VA has spent billions of dollars on the new Cerner system and said some 78 billion records have been transferred to a centralized database.
By Ron Shinkman • June 8, 2020 -
Calls mount for CMS to extend telehealth waivers
The American College of Physicians and Premier want to see pay parity and cost-sharing adjustments stay in place beyond the public health emergency declared for the COVID-19 pandemic.
By Ron Shinkman • June 5, 2020 -
Deep Dive
COVID-19 creates thicket of legal concerns for providers
"There's a push and pull here ... between offering patients protection and between providing immunities" to let providers operate without fear of prosecution, one expert said.
By Shannon Muchmore • June 5, 2020 -
Providers call CARES funds a lifeline — but some say headaches not worth risks
Legal experts Healthcare Dive spoke with had provider clients opting to return the funds, citing unwillingness to accept the terms and fears over potential risks that come with accepting the money.
By Samantha Liss • June 4, 2020 -
"White House Press Briefing". Retrieved from The White House.
Months into pandemic, Trump admin mandates labs report demographic data of COVID-19 tests
HHS is now requiring labs to submit a much broader range of demographic COVID-19 testing data, including age, race, ethnicity and sex.
By Rebecca Pifer • Updated June 5, 2020 -
BCBS plans account for nearly half of ACA enrollment, but face rising competition from Medicaid insurers
Medicaid insurers' market share on the exchanges overall ballooned from 15% of the marketplace in 2016 to 27% by 2018.
By Hailey Mensik • June 3, 2020 -
Governors plead for Trump admin to streamline testing supply distribution
"The surprise element is, here we're competing against other states and sometimes our own federal government," Colorado Gov. Jared Polis, a Democrat, told a House subcommittee Tuesday.
By Rebecca Pifer • June 3, 2020 -
CMS relaxing more value-based model requirements in wake of pandemic
The changes are aimed at minimizing reporting burden and increasing flexibilities for providers as they continue to face great financial and logistical challenges from the novel coronavirus.
By Shannon Muchmore • June 3, 2020 -
Medicaid expansion key indicator for rural hospitals' financial viability
Other factors that play a positive role include tax-exempt status and occupancy rates, according to a study in Health Affairs.
By Hailey Mensik • June 2, 2020 -
Hospitals push for release of $50B more in COVID-19 funds
The American Hospital Association wants the money for all hospitals but also hot spot areas and facilities that serve a higher number of uninsured and Medicaid members.
By Samantha Liss • June 2, 2020 -
MICHAEL PRINCE via Getty Images
Pandemic highlights need for unique patient identifier, industry tells ONC
"We want to see that ban removed and hope we can have that conversation on a national level," Mark Probst, VP and CIO of Intermountain, said at the virtual conference.
By Rebecca Pifer • June 2, 2020 -
Retrieved from Sarah Mariano, @sarahkm90 on June 02, 2020
Providers show support amid unrest: #WhiteCoatsForBlackLives
Health officials also expressed worry that the protest gatherings could further spread of the novel coronavirus. Some COVID-19 testing sites have been shut down for safety reasons, further exacerbating concerns.
By Shannon Muchmore • June 2, 2020 -
Citing lack of funding, Oklahoma withdraws planned July 1 Medicaid expansion
Millions of Americans have likely been booted off their employer-sponsored insurance and many are newly eligible for Medicaid, something the state didn't anticipate when prepping for the expansion, Republican Gov. Kevin Stitt said.
By Rebecca Pifer • June 1, 2020 -
Molina, Centene big winners in Kentucky Medicaid award
The lucrative contracts begin next year and cover 1.4 million people with an annual spend of $8 billion.
By Samantha Liss • June 1, 2020 -
Pathologists most frequent surprise billing offenders, HCCI finds
More than a third of pathologists who billed for inpatient visits did so on an out-of-network basis more than 90% of the time in 2017, according to the Health Care Cost Institute.
By Rebecca Pifer • May 28, 2020 -
BCBS plans sue CVS alleging overcharging generic prescriptions
Blue Cross Blue Shield plans in six states contend that CVS Health concealed the true cash price from the insurers for more than a decade. The plans are seeking to recoup millions from CVS.
By Samantha Liss • May 28, 2020
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