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
 

 
For U.S. community health centers, the recent announcement of $295 million in Affordable Care Act funding was welcome news. But the five-year period of mandatory ACA funding expires next September, meaning CHCs face a reduction of up to 70 percent in grant funding.
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Post date: September 19, 2014
News
National health spending is not looking so dire - at least compared to older trends, says the Centers for Medicare & Medicaid Services in it annual healthcare spending forecast, but that doesn't mean all is rosy.
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Post date: September 4, 2014
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Amid a massive backlog of hospital inpatient claims appeals at the Office of Medicare Hearings and Appeals, the Centers for Medicare & Medicaid Services is giving providers the chance to settle up and get paid - at least in large part.
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Post date: September 4, 2014
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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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In its new rules, CMS places great emphasis on the physician's documentation regarding his or her expectation of a patient's need for hospital care and anticipated length of stay. Therefore, it is essential that all hospital physicians are educated about the heightened importance of documentation within the medical record.
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Post date: September 15, 2014
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In its new rules, CMS places great emphasis on the physician's documentation regarding his or her expectation of a patient's need for hospital care and anticipated length of stay. Therefore, it is essential that all hospital physicians are educated about the heightened importance of documentation within the medical record.
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Post date: September 15, 2014
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Congress returned on Monday with just a few weeks until they adjourn to campaign. The Senate is set to adjourn by September 23 while the House could be in session for as little as 2 weeks. Here's a look at what happened in healthcare while Congress was in recess.
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Post date: September 12, 2014
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While others have dispassionately made the point that there are unexplained variations in Medicare physician billing data that warrant careful consideration when using such data, one doctor thinks CMS has devious motives.
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Post date: September 4, 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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