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
 

 
Hospitals may have less control over readmissions than clinicians, administrators or federal regulators would like to believe, new research suggests, meaning that the readmissions penalties imposed by the Centers for Medicare & Medicaid Services may be inappropriate.
Comment count:
Post date: April 23, 2014
News
As lawmakers try to understand the ultimate causes of the recent slowdown in healthcare spending growth, their determinations will eventually translate into policies that will impact healthcare businesses of all types.
Comment count:
Post date: April 16, 2014
News
Providers of Medicare Advantage and Part D plans: look out. Dozens of plans may soon be terminated.
Comment count:
Post date: April 14, 2014
News
The woman who became the face of the health law's troubled rollout last October is resigning her position as head of the country's Health and Human Services Department.
Comment count:
Post date: April 11, 2014
News
Medicare's release Wednesday of millions of records of payments made to the nation's doctors comes as the government is looking to find more cost-efficient ways to pay physicians and refashion the way the country's healthcare system is financed.
Comment count:
Post date: April 10, 2014
News
By releasing to the public a data set revealing what Medicare pays individual doctors, the Centers for Medicare & Medicaid Services says the transparency will help weed out fraud and prevent billing abuse, but physicians are crying foul.
Comment count:
Post date: April 10, 2014
News
Insurers offering Medicare Advantage plans got a bit of a reprieve this week when the Centers for Medicare & Medicaid Services gave them a rate increase instead of the expected cut. CMS' 2015 rate announcement also addressed concerns over provider terminations and beneficiary cost sharing.
Comment count:
Post date: April 9, 2014
News
When MedPAC recommended to Congress in March that readmission penalties similar to those imposed on hospitals be applied to home healthcare organizations, the home health industry didn’t balk because it has already been working toward reducing readmissions.
Comment count:
Post date: April 7, 2014
News
Health insurers offering Medicare Advantage plans may soon be feeling the effects of a court case in Connecticut.
Comment count:
Post date: April 2, 2014
News
Monday evening, the U.S. Senate managed to create an uproar in the healthcare community by passing a bill patching Medicare's pay rate for doctors instead of repealing it and delaying the ICD-10 compliance deadline.
Comment count:
Post date: April 1, 2014
News
With Medicare's "two midnight rule" set to take effect later this year and audit appeals facing lengthy backlogs, the Recovery Audit Contractor program may be headed in some new directions.
Comment count:
Post date: April 1, 2014
News
Emergency rooms across the country need to prepare themselves for an increase in ER visits as more uninsured people gain insurance under healthcare reform.
Comment count:
Post date: March 21, 2014
News
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.
Comment count:
Post date: April 8, 2014
Blog
It is now official: you must wait until 2015 to use ICD-10 code W6112XA -- struck by macaw. But it's no laughing matter: President Barack Obama has indeed signed the SGR patch legislation, which includes another delay of ICD-10 implementation.
Comment count:
Post date: April 7, 2014
Blog
Take note, hospitals: the Centers for Medicare & Medicaid Services has recently announced modifications to the implementation of the controversial "2-Midnight" inpatient admissions policy, as well as releasing the preliminary federal disproportionate share hospital allotments for FY2014.
Comment count:
Post date: March 4, 2014
Blog
For the second time in two months, Congress has turned to an extension of Medicare sequestration as a funding mechanism -- a troubling new trend for Medicare providers.
Comment count:
Post date: February 13, 2014
Blog
As a healthcare consumer, am I most interested in short-term complications and readmission rates or am I interested in getting cured of whatever I have? The recent hullabaloo over narrow networks and whether a more expensive hospital is worth it or not seems to miss the bigger point.
Comment count:
Post date: February 6, 2014
Blog
Hospitals can take a deep breath, and rest easier for at least six months. CMS is delaying enforcement of its "two-midnight" policy until after Sept. 30.
Comment count:
Post date: February 4, 2014
Blog
The Congressional Budget Office has raised the specter that reform to the Medicare physician fee schedule statutory update formula could increase the likelihood that the ACA's Independent Payment Advisory Board mechanism would be triggered potentially resulting in as much as $0.6 billion in Medicare provider cuts.
Comment count:
Post date: January 30, 2014
Blog
Yesterday the American Hospital Association, four regional hospital associations and four health systems launched a federal court challenge to the controversial two-midnight inpatient admissions policy established by the Centers for Medicare & Medicaid Services.
Comment count:
Post date: January 23, 2014
Blog
This week, CMS released a proposed rule that would make significant revisions to the Medicare Advantage and Part D prescription drug program regulations. The agency estimates that the rule changes would reduce Medicare spending by $1.3 billion between 2015 and 2019.
Comment count:
Post date: January 14, 2014
Blog
In late December, President Obama signed into law the Bipartisan Budget Act of 2013, which includes the Pathway for SGR Reform Act of 2013. While SGR drew most of the media attention, the Act includes a number of other provisions impacting the Medicare and Medicaid programs.
Comment count:
Post date: December 31, 2013
Blog
The Centers for Medicare & Medicaid Services intends to finalize the Medicaid Federal Upper payment Limits (FULs) for multiple source drugs in July 2014. This will mean less drug price variance for state Medicaid programs.
Comment count:
Post date: December 10, 2013
Blog
The Centers for Medicare & Medicaid Services has updated a handful of documents in the past week on the controversial regulations surrounding its two-midnight inpatient admissions guidance and patient status reviews.
Comment count:
Post date: November 7, 2013
Blog