| Editor's Choice: Policy & Regulation | Four states held primary elections on May 8, kicking off a busy election season that will see most Tuesdays from now until mid-September having one or more states’ voters casting ballots. Judging by the latest poll from the Kaiser Family Foundation, healthcare will be a major issue for many in the coming months. Four states held primary elections on May 8, kicking off a busy election season that will see most Tuesdays from now until mid-September having one or more states’ voters casting ballots. Judging by the latest poll from the Kaiser Family Foundation, healthcare will be a major issue for many in the coming months. | |
| In her remarks at the American Hospital Association’s annual meeting, CMS Administrator Seema Verma, MPH, offered some criticism of current accountable care organizations (ACOs) that haven’t taken on downside risk, hinting those payment models may be targeted by CMS regulations. In her remarks at the American Hospital Association’s annual meeting, CMS Administrator Seema Verma, MPH, offered some criticism of current accountable care organizations (ACOs) that haven’t taken on downside risk, hinting those payment models may be targeted by CMS regulations. | |
| As a candidate, President Donald Trump had criticized pharma companies for “getting away with murder.” In remarks on Friday, May 11, he did bash the industry’s lobbying power while also lumping in insurance companies, distributors and pharmacy benefit managers (PBMs) as part of the “broken system” that has sent drug prices soaring. As a candidate, President Donald Trump had criticized pharma companies for “getting away with murder.” In remarks on Friday, May 11, he did bash the industry’s lobbying power while also lumping in insurance companies, distributors and pharmacy benefit managers (PBMs) as part of the “broken system” that has sent drug prices soaring. | |
| Sen. Lamar Alexander, R-Tennessee, has said he’s abandoning efforts to push a bipartisan bill meant to stabilize the Affordable Care Act (ACA) exchanges, putting the blame on Democrats’ resistance to making changes to the law. With no congressional action likely this far into an election year, exchange insurers are requesting some eye-popping hikes for 2019 premiums. Sen. Lamar Alexander, R-Tennessee, has said he’s abandoning efforts to push a bipartisan bill meant to stabilize the Affordable Care Act (ACA) exchanges, putting the blame on Democrats’ resistance to making changes to the law. With no congressional action likely this far into an election year, exchange insurers are requesting some eye-popping hikes for 2019 premiums. | |
| CMS Administrator Seema Verma, MPH, spoke at a May 15 Washington Post event focused on health policy, offering some hints on where her agency’s Medicaid and Affordable Care Act (ACA) regulations may be headed. CMS Administrator Seema Verma, MPH, spoke at a May 15 Washington Post event focused on health policy, offering some hints on where her agency’s Medicaid and Affordable Care Act (ACA) regulations may be headed. | |
| HHS is the target of new lawsuits by a watchdog group for failing to respond to requests to release emails and online messages—one regarding Office of Civil Rights (OCR) officials and launching of its “Conscience and Religious Freedom Division,” the other over HHS communications with outside groups on changes to a federal grant program that provides birth control and other reproductive health services to low-income Americans. HHS is the target of new lawsuits by a watchdog group for failing to respond to requests to release emails and online messages—one regarding Office of Civil Rights (OCR) officials and launching of its “Conscience and Religious Freedom Division,” the other over HHS communications with outside groups on changes to a federal grant program that provides birth control and other reproductive health services to low-income Americans. | |
| If participants in the Medicare Shared Savings Program (MSSP) are required to move into a track which involves downside risk for their organization, they’re likely to leave the program altogether, according to the results of a survey from the National Association of Accountable Care Organizations (NAACOS). If participants in the Medicare Shared Savings Program (MSSP) are required to move into a track which involves downside risk for their organization, they’re likely to leave the program altogether, according to the results of a survey from the National Association of Accountable Care Organizations (NAACOS). | |
| CMS published several of its annual proposed Medicare payment rules on Friday afternoon, covering a slew of facilities like nursing homes, hospices, inpatient rehabilitation and psychiatric hospitals. As predicted, the proposed rule also included regulatory changes in line with CMS initiatives on reducing administrative burden and granting patients easier access to their own data. CMS published several of its annual proposed Medicare payment rules on Friday afternoon, covering a slew of facilities like nursing homes, hospices, inpatient rehabilitation and psychiatric hospitals. As predicted, the proposed rule also included regulatory changes in line with CMS initiatives on reducing administrative burden and granting patients easier access to their own data. | |
| In states that choose to utilize federal grants for the pilot program, those who don’t want coverage would have to actively opt out of plans within 60 days. In states that choose to utilize federal grants for the pilot program, those who don’t want coverage would have to actively opt out of plans within 60 days. | |
| Fewer quality measures, a shorter reporting period for Meaningful Use requirements and an increase in uncompensated rate payments were all positives in the eyes of hospitals in their initial reaction to the proposed 2019 Medicare Inpatient Prospective Payment System (IPPS) rule. Fewer quality measures, a shorter reporting period for Meaningful Use requirements and an increase in uncompensated rate payments were all positives in the eyes of hospitals in their initial reaction to the proposed 2019 Medicare Inpatient Prospective Payment System (IPPS) rule. | |
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