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Policy

 

Organizations representing hospitals and specialties reacted negatively to an estimate the Affordable Care Act (ACA) replacement passed by House Republicans would result in 23 million fewer people having insurance by 2026.

The Congressional Budget Office has released its updated report on the American Health Care Act (AHCA), saying the Affordable Care Act (ACA) replacement passed by House Republicans would still erase the recent gains in insurance coverage and potentially price less healthy enrollees out of the individual market.

The full fiscal year 2018 budget proposal for HHS would include deep cuts to Medicaid, while making immediate cuts to National Institutes of Health (NIH), the Office of the National Coordinator for Health IT (ONC) and almost all HHS agencies. 

The proposed single-payer healthcare system being debated in California would come with a $400 billion annual price tag—more than double the state’s annual budget—according to a review released by the California Senate Appropriations Committee.

The Trump administration has asked for a 90-day delay on a ruling which could end Affordable Care Act (ACA) subsidies to insurers, pushing back a potentially market-destabilizing move but offering little assurance to actuaries working on 2018 rate requests for the ACA exchanges.

 

Recent Headlines

AMA spent millions only to get another SGR fix

Tuesday, President Obama signed H.R. 4302 into law. It is the 17th temporary sustainable growth rate (SGR) formula fix passed by Congress, but the first such fix actually opposed by the American Medical Association (AMA), which had spent millions to try to win a permanent repeal.

Temporary SGR fix and ICD-10 delay near certain as Senate readies vote

On Monday, the U.S. Senate is scheduled to take up the temporary sustainable growth rate formula (SGR) fix and one-year ICD-10 delay that was pushed through the House in dramatic fashion on Thursday.

Washington state hospitals face stricter state controls over partnerships

As of last week, hospitals operating in Washington state face new requirements to obtain a Certificate of Need from the state before affiliating with other hospitals. In addition, they must disclose their policies on admissions, nondiscrimination, end-of-life care and reproductive health care to the state.

House GOP seals deal on end of full SGR repeal

Without bi-partisan agreement on how to pay for a full repeal of the near universally reviled sustainable growth rate (SGR) formula that would cut Medicare physician reimbursement by about one fourth starting on April 1, House Republicans posted a one-year SGR fix to the Rules Committee website three minutes before midnight last night. The new bill also delays ICD-10 implementation until Oct. 1, 2015.

McDermott pushes HHS to fix RAC appeals backlog now

The backlog of appeals pending with the Office of Medicare Hearings and Appeals has grown so large that it is beginning to affect Medicare beneficiaries directly, and that has gotten the attention of Rep. Jim McDermott (D-Wash.), a ranking member of the powerful Committee on Ways and Means Subcommittee on Health.

AMA Drops Support For Permanent SGR Fix that Delays Individual Mandate

The American Medical Association (AMA) on Thursday took the unusual step of writing to Congress to express its disappointment in the current proposal to pay for a permanent repeal of the sustainable growth rate (SGR) formula by delaying the Affordable Care Act’s mandate that individuals must purchase insurance or pay a penalty.

More Than 200 Legislators Urge CMS to Leave Medicare Advantage Rates Alone

Although the proposed cuts to the Medicare Advantage program announced last month were not as deep as some had feared, the opposition mounted by the insurance industry and legislators has been fierce.

Legislators Seek to Reduce Readmission Penalties on Hospitals Treating Poor

The bill H.R. 4188, the Establishing Beneficiary Equity in the Hospital Readmission Program Act, would require the Secretary of the Department of Health and Human Services (HHS) to adjust the readmission penalty based on a hospital’s share of dual eligible patients.

SGR Repeal Faces a New Threat: Politics

House Republicans may tie passing a permanent repeal of the sustainable growth rate (SGR) formula to delaying the Affordable Care Act (ACA) individual mandate on buying health insurance.

Doctors Seek CMS Help on ACA Insurer Rule that Puts Practices at Risk

Current requirements for when insurers must tell physician practices that a patient’s Affordable Care Act (ACA) insurance exchange purchased health plan is in danger of being cancelled could leave doctors unreimbursed for their services warned more than 80 state and national organizations in a letter to CMS.

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