Medicare Payment and Reimbursement

340B advocacy group releases survey results showing the financial toll of drug manufacturers’ curbs on discounts

Among hospitals participating in the 340B Drug Pricing Program, a new report finds that steps taken by drug manufacturers to restrict discounts have had a significant impact.

Nick Hut February 2, 2022

News Briefs: Supreme Court ruling allows the COVID-19 vaccine mandate for healthcare workers to proceed

A roundup of top news stories for healthcare finance professionals.

Nick Hut February 1, 2022

Healthcare News of Note: McKinsey analyzes a range of scenarios based on the infectiousness, immune evasion and severity of disease linked to the omicron variant

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: An in-depth analysis looked at what the U.S. can expect with the onslaught of the omicron variant, CMS rescinded a drug pricing model, and total healthcare utilization in 2020 dipped below 2019 levels.

Deborah Filipek January 28, 2022

Survey: Health systems push toward risk-based payment models, payer-provider partnerships

Check out the key takeaways from a survey conducted in Summer 2021 with healthcare executives, which focused on risk-based models, data issues, leaders’ concerns on hitting budgets and more.

Crystal Milazzo January 28, 2022

Hospitals need federal support to handle the ongoing staffing and financial crunch, industry leaders say

The hospital industry issued its latest plea for additional federal help to mitigate the financial and operational strain of COVID-19, including surging staffing costs.

Nick Hut January 26, 2022

The COVID-19 vaccine mandate for healthcare workers can take effect nationwide, Supreme Court says

The court lifted injunctions that had halted implementation of the COVID-19 vaccine mandate in half the country, leaving hospitals and other affected providers with likely only a few weeks to begin complying.

Nick Hut January 21, 2022

Coverage denials based on medical necessity are far more likely to arise from Medicare FFS rules than from MA plan policies

Coverage rules stemming from Medicare national and local determinations were the most likely cause of claim denials in one Medicare Advantage plan.

Nick Hut January 18, 2022

CMS proposes to restrict Medicare coverage of a high-profile new Alzheimer’s drug

Medicare will pay for use of a new drug to treat Alzheimer’s disease only for patients in approved clinical trials, CMS said in a proposed coverage determination.

Nick Hut January 12, 2022

CMS now says hospitals in half the country must abide by the COVID-19 vaccine mandate starting in late January

The status of the COVID-19 vaccine mandate for healthcare workers took another twist, with CMS stating it will look to enforce the mandate within a month in 25 states and Washington, D.C.

Nick Hut January 1, 2022

A White House plan to combat the omicron variant includes support for hospitals

The Biden administration announced several provisions to bolster hospitals as efforts to contain the COVID-19 pandemic enter a third calendar year.

Nick Hut December 22, 2021
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