Congress Pushes 340B Bills to Cut Eligibility, Increase Reporting
July 11—Members of Congress this week pushed emerging legislation to restrict the ability of hospitals and other providers to qualify for the 340B discount drug program and to increase their reporting requirements.
MA Gets Better Outcomes Despite Sicker Enrollees: Study
July 10—Contrary to general belief, Medicare Advantage (MA) plan enrollees are initially sicker than those in fee-for-service (FFS) Medicare, according to new research. And once enrolled, MA beneficiaries get better care at a lower cost.
Azar Promises Drugmaker Penalty Rule Coming
July 9—A five-times-delayed rule that would stiffen drugmaker penalties—among other provisions—will be implemented, the Trump administration’s healthcare policy leader told providers on Monday.
Transparency, Interoperability, DSH Changes Lead Hospital IPPS Concerns
July 6—Hospital advocates recently raised a range of concerns about proposed Medicare payment policy changes, including transparency and interoperability requirements and a new way to calculate uncompensated care payments.
Pilot to Offer APM Bonuses to Physicians in Medicare Advantage
July 3—Medicare plans to launch a pilot—as soon as this year—to allow physicians paid through Medicare Advantage value-based arrangements to qualify for the same bonuses as those working in advanced alternative payment models.
Definition of “Employer” under Section 3(5) of ERISA – Association Health Plans Final Rule Executive Summary
This document summarizes the Employee Benefits Security Administration's Association Health Plans final rule, published in the June 21, 2018, Federal Register.
Who’s Afraid of a Little Risk?
The Medicare ACO modeled advanced by CMS has encountered some challenges, but it still holds promise if CMS addresses the flawed idea of retrospective attribution of patients to an ACO.
Physician Distribution, Mobility, Fair Market Value and Compensation Surveys
An analysis of regional differences in physician compensation coupled with the general tendency against long-distance relocation shows there is no truly national market for established physicians. Rather, local market conditions must be considered in setting fair market value.
HFMA Comments on FY2019 IPPS Proposed Rule
HFMA submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the FY2019 IPPS proposed rule published in the May 7, 2018, Federal Register.
Trump Administration to Replace Value-Based Payment Goal
June 20—Department of Health and Human Services (HHS) Secretary Alex Azar II has rejected the Obama administration’s goal of shifting 50 percent of Medicare payments to value-based payment models by the end of 2018.