Payment Reimbursement and Managed Care

Update on Medicare payment policy for treatments involving bamlanivimab

Medicare no longer will pay healthcare providers for administering the COVID-19 treatment bamlanivimab now that the FDA has revoked the Emergency Use Authorization for treatments in which the drug is administered alone.

Nick Hut April 20, 2021

CMMI announces Direct Contracting participants but cancels second round of applications

The Center for Medicare & Medicaid Innovation announced the 53 entities that have been accepted as participants in the new Global and Professional Direct Contracting model.

Nick Hut April 9, 2021

HHS delays implementation of rule requiring FQHCs to provide insulin, epinephrine at 340B prices

HHS has postponed a Trump administration regulation that would require federally qualified health centers to make certain drugs more affordable for low-income patients and will consider whether to withdraw the rule altogether.

Nick Hut March 24, 2021

Disproportionate Share Hospital funding to states doesn’t match up with key benchmarks, report finds

Disproportionate Share Hospital payments don’t always align with key metrics such as uninsured rates and uncompensated care costs, a new policy report finds.

Nick Hut March 17, 2021

RAND report finds regulating hospital prices would be the most effective way to reduce healthcare spending, but are the proposals viable?

The American Hospital Association had a negative reaction to study findings showing that regulation of hospital prices would be the most effective way to reduce prices paid by commercial insurers.

Nick Hut February 21, 2021

Hospital groups ask Supreme Court to reverse payment cuts to 340B hospitals, off-campus provider-based departments

The American Hospital Association and other hospital groups are challenging 2020 appeals court decisions that allow HHS to continue slashing payments to 340B hospitals and to off-campus provider-based departments.

Nick Hut February 16, 2021

Biden’s order to reopen the ACA marketplaces next month draws praise from hospitals

An executive order by President Joe Biden directed HHS to open the Affordable Care Act marketplaces for three months starting in mid-February.

Nick Hut January 30, 2021

Employers seek shelter from healthcare cost increases in public option

If plans and providers can’t collaborate to control healthcare cost, employers will look to the government to do so.

Chad Mulvany, FHFMA January 22, 2021

Post-election Washington policy outlook on health policy priorities

HFMA's Chad Mulvany speculates on health policy priorities and changes in the next 24 months, assuming we continue to have a divided government and President-elect Biden's campaign survives President Trump's many legal challenges about state vote counts.

Chad Mulvany, FHFMA January 22, 2021

Analysis: Providers should prepare for reductions in Medicare and Medicaid spending as federal deficit swells

Given the role both Medicare and Medicaid spending play in current and projected federal deficits, spending on both will eventually need to be reduced.

Chad Mulvany, FHFMA January 22, 2021
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