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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

CMS cuts red tape to save providers millions

The Centers for Medicare & Medicaid Services (CMS), has issued a set of final regulatory changes that it says will save healthcare providers nearly $660 million annually, and $3.2 billion over five years.

AHA members bring long list of issues to the Hill

American Hospital Association (AHA) members and leaders were in Washington, D.C., this week for the AHA Annual Membership Meeting and lobbied their members of Congress on many of the top issues outlined in the association’s 91-page-long 2014 Advocacy Agenda.

2015 inpatient PPS rates rule also expands price transparency

The Centers for Medicare and Medicaid Services has issued its hospital inpatient prospective payment system (PPS) and long-term care hospital PPS proposed rule for fiscal year 2015, and included in the rule is a requirement that hospitals begin publically posting what they charge for services by October 1.

Florida legislature may double number of PAs physicians can supervise

The Florida House of Representatives has passed by a margin of 100 to 19 a bill to increase the number of physician assistants (PAs) a single physician may supervise from four to eight. The Florida Senate will consider the bill next.

Rep. McDermott pushes FTC for more guidance on health system mergers

Rep. Jim McDermott (D-Wash.) has asked the Federal Trade Commission to do more to clarify how it will approach enforcement of the Clayton Act on hospital and health system mergers when many of the provisions in the Affordable Care Act encourage healthcare consolidation.

OIG recommends lowering Medicare rates for low-risk outpatient surgeries, CMS balks

Noting that the government could save as much as $15 billion, the Office of Inspector General (OIG) has urged the Centers for Medicare and Medicaid Services (CMS) to equalize payment rates for low-risk surgeries performed in hospital outpatient settings with those done at ambulatory surgery centers (ASCs), but so far CMS is not enthusiastic about the idea.

AHA and hospitals challenge two-midnight rule in federal court

The American Hospital Association, four state hospital associations and four hospital/healthcare systems are taking the Centers for Medicare & Medicaid Services to court over its controversial two-midnight rule that restricts inpatient payment to only be appropriate in cases where the admitting physician expects that the patient will stay in the hospital long enough to cover at least two midnights.

Senate Finance chair renews call for permanent SGR Fix

Senator Ron Wyden (D-Ore.) used his opening remarks in a hearing on health and human services spending in the president’s Fiscal Year 2015 budget to continue to urge a permanent repeal for the sustainable growth rate (SGR) formula used to calculate Medicare physician payments.

CMS releases individual physician payment data

The Centers for Medicare and Medicaid Services left many physicians feeling exposed as data on individual payments were released to major newspapers ahead of the agency posting the data on its website.

CMS backs down on Medicare Advantage cuts

The final 2015 Medicare Advantage rates announced Monday by the Centers for Medicare and Medicaid Services reflected only a 0.4 percent decrease, but that did not win it the adulation of America’s Health Insurance Plans’ (AHIP), the organization that represents U.S. insurance companies.

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