Policy and Legislation

Stories on healthcare policy focus on subjects such as the financing and delivery of healthcare, quality of care, and access to care. Policy stories often deal with the federal, state and local institutions responsible for regulating the healthcare industry and setting reimbursement rates for providers.

RELATED STORIES:
Medicare trust fund to be exhausted by 2017, report reveals
CMS releases final 2010 hospital inpatient payment rule
 

 
In its June report to Congress, MedPAC made recommendations that would change the way post-acute care providers are reimbursed. Reviews from providers are mixed.
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Post date: August 27, 2014
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A newly released scorecard by the AARP Policy Institute, with support from The SCAN Foundation and The Commonwealth Fund, ranks states on how well each delivers long-term services and supports to older adults and people with disabilities.
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Post date: August 20, 2014
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The ACA created the Center for Medicare and Medicaid Innovation to launch experiments in every state, changing the way doctors and hospitals are paid, building networks between caregivers and training them to intervene before chronic illness gets worse, but one of the biggest experiments is the center itself.
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Post date: August 11, 2014
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The Department of Health and Human Services announced today that providers, payers and clearinghouses must transition to the classification system by Oct. 1, 2015.
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Post date: August 1, 2014
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Medicare's Hospital Insurance Trust Fund won't run out of money until 2030. That’s four years later than projected last year and 13 years later than projected the year before the passage of the Affordable Care Act.
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Post date: July 29, 2014
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A Pennsylvania provider is suing a health insurance company for passing on its 2 percent reimbursement cut required by sequestration.
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Post date: July 29, 2014
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Although a May 2014 U.S. District Court ruling vacated HRSA's 340B orphan drug regulation, the agency has issued an interpretive rule affirming its policy on the orphan drug exemption. The pharma industry is up in arms, but what does it all mean?
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Post date: July 25, 2014
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If we can identify the "underlying path" of health spending, we can do a better job of predicting the future from a noisy history. This underlying path can also serve as the curve to be monitored for evidence of any "bend."
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Post date: July 17, 2014
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If we don't fundamentally change the way we pay for healthcare, we won't change the economic principles that continue to drive the rapid growth in healthcare spending. Let's pay physicians and hospitals based on the health problems their patients have.
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Post date: July 15, 2014
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Hospices can now lose Medicare payments if they don’t file cost reports, and yet, because there are no penalties for inaccurate reporting, there is little motivation to spend much time on them.
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Post date: July 11, 2014
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Medicare regulators are updating hospital outpatient and ambulatory surgery center payments for next year, and also outlining a potential remedy to private Medicare overpayments.
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Post date: July 10, 2014
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A quarter of the nation's hospitals in October will receive lower Medicare payments because their rates of patient complications are higher than their peers. Here is an explanation of the three measures Medicare is using to calculate the hospital-acquired conditions scores.
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Post date: June 24, 2014
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Last month the Centers for Medicare & Medicaid Services published its proposed rule to update the Medicare Hospital Outpatient Prospective Payment System and the Ambulatory Surgical Center Payment System rates and policies for calendar year 2015. Here's what you need to know.
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Post date: August 6, 2014
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Medicaid beneficiaries deserve the same access to healthcare services and products as people with commercial insurance or Medicare. But since Medicaid pays doctors and hospitals 27 to 65 percent less than commercial health plans, it makes it awfully difficult for providers to be payer agnostic.
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Post date: July 23, 2014
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Business has a vital concern in the financing of healthcare. So why is there not an outcry to switch to a proven financing system that would serve their employees well?
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Post date: July 17, 2014
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One of the worst failures of the Affordable Care Act is that, even with subsidies, the premiums and out-of-pocket expenses are unaffordable for far too many people. Unfortunately, a new proposal for catastrophic plans with very high deductibles would make accessing healthcare truly unaffordable for even more people.
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Post date: June 16, 2014
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Hospital revenue fell in 2014's first quarter compared with the final three months of 2013, the Census Bureau estimated last week. And for a full year -- from Q1 2013 to Q1 2014 -- revenue for healthcare and social assistance rose only 2.9 percent.
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Post date: June 16, 2014
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The Affordable Care Act requires employers to provide coverage for full-time employees, but not part-timers. That sounds like a straightforward and reasonable provision, but as usual the devil is in the details.
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Post date: June 12, 2014
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The Federal Trade Commission's blocking of hospital and physician practice mergers, as a way to purportedly prevent monopolies, is hurting the very people the FTC claims to be helping -- the patients themselves.
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Post date: May 28, 2014
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CMS has just released a proposed rule that would require Medicare prior authorization for certain Medicare Durable Medical Equipment items that the agency characterizes as "frequently subject to unnecessary utilization." The decisions would not be subject to appeal.
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Post date: May 23, 2014
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While a referral arrangement reversal has upset the applecart for some, most providers are taking it in stride.
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Post date: May 15, 2014
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Late last week, the Health Resources and Services Administration released the results of its FY 2012 audits of covered entity compliance with 340B drug discount program rules. The agency discovered several "recurring critical areas of non-compliance" for healthcare facilities.
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Post date: May 14, 2014
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Twenty-four states, including almost the whole South, took the stubborn path and have so far refused to expand Medicaid. That's a big reason rural hospitals are continuing to struggle.
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Post date: May 13, 2014
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Thomas Piketty’s new book “Capital in the Twenty-First Century” is not about healthcare, but it provides us with an excellent background for understanding why we need to reform our current healthcare financing system.
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Post date: April 8, 2014
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