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Policy

 

Adding to opposition already expressed by physician and hospital groups, America’s Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association (BCBSA) came out against the Graham-Cassidy legislation to repeal and replace the Affordable Care Act (ACA).

CMS Administrator Seema Verma, MPH, said the Trump administration will take the Center for Medicare and Medicaid Innovation (CMMI) in a “new direction,” claiming the policies under the last administration encouraged consolidation and providers need more “freedom” to design new care delivery models.

Once thought to be the policy equivalent of a Hail Mary pass, the plan to replace the Affordable Care Act (ACA) known as the Graham-Cassidy bill appears to have gained momentum—and with it, extra attention from healthcare industry groups like the American Medical Association (AMA) that have opposed Republicans’ so-far unsuccessful efforts to repeal the law.

Amid attempts to agree on short-term stabilization of the Affordable Care Act (ACA) and Democrats coming out in support for a “Medicare-for-all” bill, a group of Republican senators unveiled what could be their last chance to repeal and replace the ACA.

Members of the Senate Health, Labor, Education and Pensions (HELP) Committee were encouraged to offer greater flexibility under the Affordable Care Act’s “state innovation waivers,” the details of which could spell trouble for the fledging compromise between Democrats and Republicans on a quick fix for the law.

 

Recent Headlines

Medicare wellness visits causing confusion

When the Affordable Care Act first went into effect, one of the perceived benefits for physicians was the three new billing codes that cover various “wellness visits” for Medicare Part B patients. But so far, the perk is failing to live up to expectations. 

Medicare’s 3-day hospital stay better off waived: analysis

Medicare has long required a three-day hospital stay before it will pick up the tab for a senior to move into a skilled nursing facility. A new data crunch shows that waiving this prerequisite shortens costly and risky hospital stays—without driving up admissions to skilled nursing facilities or lengthening stays therein.

AHA implores feds to put Anthem-Cigna through the wringer

The American Hospital Association is urging the U.S. Department of Justice to take a hard look at Anthem’s planned $48.4 billion purchase of Cigna.

Transparency in clinical trials proving effective at advancing science rather than careers

Researchers are as subject to human nature as anyone else and so may be inclined to only publish, or at least to slant study design and conclusions toward, positive results of clinical trials. 

CMS paying 6,000-plus doctors bearing ‘credentials’ from defunct medical schools—but it’s not as bad as it looks

In order to bill Medicare—in fact, just to be eligible to practice medicine—a physician must hold a degree from an accredited medical school. Yet Medicare’s provider database contains the names of more than 6,000 doctors whose credentials trace to medical schools that have been out of business for decades. 

Did Medicare just restart the ‘death panels’ debates?

Six years after former Alaska Gov. Sarah Palin famously warned Americans about the approach of “death panels” if the Affordable Care Act passed into law, the political firestorm that subsequently flared up and died down may be about to re-ignite.

American Hospital Association CEO agrees with SGR repeal legislation

American Hospital Association CEO Rich Umbdenstock sent letters to members of Congress on March 24 saying the organization agreed with bipartisan legislation to repeal the Sustainable Growth Rate (SGR) formula.

More than 16 million uninsured people gain coverage since 2010

Since the passage of the Patient Protection and Affordable Care Act five years ago, 16.4 million uninsured people have obtained coverage.

Hospitals worry about King v. Burwell Supreme Court ruling

If the Supreme Court rules in favor of the plaintiffs, hospitals will suffer because millions of people will not be able to afford health insurance, McClatchy reports.

Affordable Care Act remains divisive

Equal percentages of poll respondents have a favorable and unfavorable view of the Affordable Care Act.

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