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Policy

 

Massachusetts Gov. Charlie Baker signed a law on Nov. 21 to require insurers cover birth control products without copays, allow women to obtain a year’s supply at once and prevent most employers from opting out of contraceptive coverage on moral or religious grounds.

Alex Azar, President Donald Trump’s nominee for HHS Secretary, was paid nearly $2 million in his final year as an executive at pharmaceutical giant Eli Lilly and built a portfolio worth as much as $20.6 million in his nearly 10-year tenure at the company.

Several changes to Medicare Advantage and Medicare Part D prescription drug plans have been included in a proposed rule by CMS in an effort to fight opioid abuse among seniors while taking another step towards reducing regulations.

Between Nov. 1 and Nov. 11, nearly 1.5 million people signed up for health insurance coverage on the Healthcare.gov exchange, an increase of almost 500,000 from the same period last year.

Republican leaders in the Senate announced Nov. 14 they will include a repeal of the Affordable Care Act’s individual mandate in their tax reform proposal. After failing numerous times to repeal and replace the ACA, GOP leaders are hoping to include the healthcare reform in the tax bill.

 

Recent Headlines

Mishandled patient record drop off costs Parkview Health System $800,000

Indiana and Ohio non-profit Parkview Health System has reached a deal with the U.S. Department of Health and Human Services Office for Civil Rights (OCR) to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule that occurred when boxes of medical records were delivered to the home of a retiring doctor when she was not there.

Senate bill seeks to make patient socioeconomic status a factor in assessing readmission penalties

If enacted, the bi-partisan Senate bill would change Medicare’s Hospital Readmissions Reduction Program to avoid possibly unfairly penalizing hospitals that treat a greater percentage of poor, Medicare and Medicaid dual-eligible patients.

Court finds Washington State exceeded its authority in requiring a certificate of need for all hospital affiliations

A Thurston County Superior Court judge has invalidated a change in the Washington State Department of Health's Certificate of Need rules that would have required hospitals to first get approval from the state for all business relationships where there is “any change of control” in “any part” of a hospital.

Cantor loss changes picture for healthcare lobbying efforts

News media and pundits have largely focused on what House Majority Leader Rep. Eric Cantor’s Virginia Republican primary loss to David Brat means for immigration reform, but Cantor was also heavily involved in drafting the Republican alternative to the Affordable Care Act (ACA).

3 priorities of Burwell’s WalMart past that could inform her HHS future

Sylvia Mathews Burwell, President Obama’s pick to replace Kathleen Sebelius as Secretary of the U.S. Department of Health and Human Services (HHS) sailed through her Senate confirmation with a vote of 78 to 17 in favor of confirming her nomination.

AHA to Sebelius: Stop “Kafkaesque” OIG audits of hospital claims

Whether it is the heights of hyperbole or an accurate description may depend on your perspective, but Rick Pollack, executive vice president of the American Hospital Association (AHA) did not mince words in his 10-page letter to outgoing U.S. Department of Health and Human Services Secretary Kathleen Sebelius about the many problems with the Office of Inspector General (OIG) getting into the act of reviewing Medicare Part A payment claims for short-stay hospital admissions.

Study finds newly insured will not make up for ACA cuts to Disproportionate Share Hospitals

The expansion of health insurance under the Affordable Care Act (ACA) should mean fewer uninsured patients at Disproportionate Share Hospitals (DSHs), but estimates for just how many fewer such patients would need care might have been overly optimistic finds a new study on California hospitals appearing in Health Affairs.

OIG: Physicians make mistakes in more than half of E/M claims

According to the OIG’s review of a random sample of 657 evaluation and management (E/M) Medicare claims from 2010, more than half (55 percent) had coding and/or documentation errors. Of these, vastly more were upcoded rather than downcoded. If the sample’s findings hold true for all Medicare E/M claims, it means the government is probably overpaying for E/M services by around $6.7 billion, the OIG concluded.

Rep. Blumenauer tries once more for Medicare benefit expansion into hospital-to-home transition services

House Rep. Earl Blumenauer (D-Ore) re-introduced his bipartisan Medicare Transitional Care Act in the 113th Congress on Thursday. The bill seeks to create a new benefit to support and coordinate care for Medicare beneficiaries as they move from the hospital setting to their homes or other care setting.

Register now to check accuracy of industry payments CMS will attribute to you under Sunshine Act

Physicians and teaching hospitals that want the chance to review information about payments or other transfers of value they’ve received from pharmaceutical, medical device and other industry groups before this information is made public should register with the Centers for Medicare and Medicaid Services (CMS) starting Sunday, June 1, 2014.

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