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Policy

 

President Donald Trump is considering nominating Alex Azar, a former executive for pharmaceutical giant Eli Lilly, as the next secretary of HHS, which could place the agency in the hands of man who has been skeptical of value-based care and opposed drug price controls.

Sens. Lamar Alexander, R-Tennessee, and Patty Murray, D-Washington, have told reporters they’ve reached an agreement to fund the Affordable Care Act (ACA)’s cost-sharing reduction subsidies to insurers which had been halted by President Donald Trump.

Groups representing physicians, hospitals and patients came out largely in opposition to President Donald Trump’s executive order to encourage the use of insurance plans which don’t comply with Affordable Care Act (ACA) regulations on benefits and covering people with pre-existing conditions.

Cost-sharing reduction subsidies, or CSRs, paid to insurers in exchange for keeping out-of-pocket costs low for lower-income Affordable Care Act (ACA) exchange enrollees will end, HHS announced Thursday night, with the agency saying it couldn’t legally continue making the payments.

President Donald Trump signed an executive order on the morning of Oct. 12 to ease rules on small businesses buying health insurance. With Congress failing to act on Republican promises to repeal and replace the Affordable Care Act (ACA), Trump will make the unilateral move to reconfigure federal regulations.

 

Recent Headlines

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.

Final 2015 Medicare Advantage cuts could come Monday

The proposed 2015 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies are scheduled to be finalized on Monday, at which point providers and health plans will find out if they will see another cut to the Medicare Advantage program next year.

CMS to release individual Medicare physician payment data

As early as next week, the Centers for Medicare and Medicaid Services plans to release data on what it pays doctors at the individual physician level, a move long opposed by physician groups such as the American Medical Association (AMA).

States may offer solution to ACA grace period problem

Washington state has passed the first law to require insurers to quickly notify physicians when patients enrolled in exchanges under the Patient Protection and Affordable Care Act (ACA) stop paying their premiums, and other states may follow its lead.

GOP budget proposal has drastic changes and steep cuts for healthcare

The fiscal year 2015 budget the House Budget Committee marks up today would cut about $2.9 trillion in health care spending over 10 years and turn Medicare into a premium support program.

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