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Policy

 

The Center for American Progress (CAP), a liberal-leaning think tank, has added a proposal to the debate on how to achieve universal health coverage but without moving the U.S. to a single-payer healthcare system—though providers would be paid less than they currently are by private insurance and hospitals would need to adapt to a big expansion of bundled payments.

Under a newly proposed rule from HHS, short-term health insurance coverage that doesn’t comply with the Affordable Care Act (ACA) would be more widely available, which the agency admitted may lead to insurer losses on the ACA exchanges if younger, healthier customers leave that market to buy short-term plans.

For two decades, the Centers for Disease Control and Prevention (CDC) has supposedly been blocked from conducting research into the health effects of gun violence by a budget amendment. HHS Secretary Alex Azar has a different opinion, telling members of Congress Thursday he would allow the CDC to conduct research which doesn’t veer into advocacy.

Providers have until March 12 to apply for CMS’s new Bundled Payments for Care Improvement (BPCI) Advanced model, though the program was only unveiled on Jan. 9. Considering the details CMS has given about the model, that’s not enough time for hospitals to decide whether to participate, according to the American Hospital Association (AHA).

In his first congressional testimony since being confirmed as HHS Secretary, Alex Azar argued the department’s proposed budget would extend the life of Medicare while making HHS more efficient by cutting nearly $18 billion in funding.

 

Recent Headlines

OIG to Look For Additional Kwashiorkor Fraudulent Billing in 2014

The 2014 Office of Inspector General (OIG) Workplan promises that the agency will look for more cases of hospitals miscoding malnutrition cases in Medicare patients as cases of kwashiorkor. Already this year, the agency has reached settlements with Mercy Medical Center, in Des Moines, Iowa, and Christus Saint Vincent Regional Medical Center, in Santa Fe, N.M., over incorrect billing for kwashiorkor in a combined total of 217 patients who actually did not have the disease.

5 Things the SGR Bill Does Besides Fix Doc Pay

The H.R. 4015/S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, bills also contain provisions that impact more than just physician pay. Among the provisions tucked inside the bill are these five.

CMS Resets Clock on 2-Midnight Rule

A Centers for Medicare and Medicaid Services (CMS) decision to delay the date when Recovery Audit Contractors (RACs) will start looking for inpatient claims that should have been billed as outpatient observation because of their short duration (less than a day defined as two midnights in the hospital) will buy hospitals and the groups that represent them time to fight CMS-1599-F (commonly known as the “2-Midnight Rule”).

HHS Gives Patients Direct Access to Lab Results

The U.S. Department of Health and Human Services (HHS) has amended rules covering how laboratory test results are communicated to patients to allow patients to skip going through their physician to get access to their test results.

ACA Preparedness: How to Conduct a Community Health Needs Assessment

Non-profit hospitals have to do it every three years to comply with the requirements of the federal Patient Protection and Affordable Care Act (ACA), but probably any hospital or clinic would benefit by conducting a Community Health Needs Assessment (CHNA).

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