Policy and Regulation

Resource Constraints Trouble Hospital Price Transparency Compliance

by Jacqueline LaPointe

About 30 percent of hospitals are not complying with a hospital price transparency rule that went into effect on Jan. 1, 2021, according to a new analysis from Guidehouse. Researchers at the...

Hospitals Ask Supreme Court to Take Up 340B, Site-Neutral Payments

by Jacqueline LaPointe

The American Hospital Association (AHA), joined by member hospitals and other national organizations, have filed petitions asking the Supreme Court to reverse two appeals court decisions impacting...

Primary Care Needs Telehealth Reimbursement, Targeted Relief

by Jacqueline LaPointe

Better-targeted federal relief, continued telehealth reimbursement, and help acquiring personal protective equipment are some ways primary care providers can maintain financial stability as the...

Spotlight on the Biden Administration’s Healthcare Team

by Jacqueline LaPointe

Healthcare remains one of the top priorities for the Biden administration as it inherits an ongoing pandemic and the unstable future of the Affordable Care Act. But the President is already unveiling...

Groups Want Medicare Sequester Moratorium Through End of PHE

by Jacqueline LaPointe

Healthcare organizations from across the care continuum are calling on Congress to act before the moratorium on the 2 percent Medicare sequester expires on Mar. 31, 2021. Congress has paused the...

Biden Administration Inherits Slew of Medicare Regulatory Changes

by Jacqueline LaPointe

Nearly all Medicare providers have been impacted by at least one COVID-19 pandemic-related regulatory change, the Commonwealth Fund reports. Under the Trump administration, there were 244 Medicare...

A New Administration, Value-Based Payment to Dictate 2021 Success

by Jacqueline LaPointe

2021 may not have started as the fresh page everyone was hoping for, but a new administration could be making some well-worn strategies more relevant. In a new Healthcare Strategies podcast, the...

Not All Hospitals Complying with New Price Transparency Rule

by Jacqueline LaPointe

Hospitals are struggling to comply with new price transparency requirements from CMS that took effect on Jan. 1, 2021. A new analysis from healthcare consulting firm ADVI found inconsistent and...

HHS Pushes Back Deadline for Provider Relief Fund Reporting

by Jacqueline LaPointe

HHS has amended the Provider Relief Fund reporting timeline in order to give those who received over $10,000 in payments more time to attest how they used the funds. The federal department announced...

How Biden’s COVID-19 Relief Plan Could Impact Hospitals

by Jacqueline LaPointe

Soon after the crowds disperse from the Capitol on Jan. 20, 2021, newly minted President Joe Biden will be working to enact a roughly $1.9 trillion COVID-19 relief plan that will impact hospitals and...

FTC Announces Plan to Study Physician Group Mergers

by Jacqueline LaPointe

The Federal Trade Commission (FTC) has announced plans to study the effects physician group mergers and other recent healthcare facility consolidation deals have had on competition. In the Jan. 14...

HHS Secretary Alex Azar Resigns, Effective Jan. 20

by Jacqueline LaPointe

Alex Azar has resigned as head of HHS to make room for President-elect Joe Biden’s pick for HHS Secretary following his inauguration on Jan. 20, 2021. Azar was sworn in as the 24th HHS Secretary...

CMS Defines “Reasonable and Necessary” Medicare Coverage

by Jacqueline LaPointe

CMS has codified how it defines “reasonable and necessary” coverage for items and services that may be covered under Medicare Parts A and B in a new final rule. The rule finalized on Jan....

Surprise Billing Arbitration Favors Providers, But Rates Are High

by Jacqueline LaPointe

An out-of-network surprise billing solution in New Jersey favors providers, paying them significantly more than in-network prices for the set of services in dispute, according to a new Health Affairs...

CMS to Expand Home Health Value-Based Purchasing Model

by Jacqueline LaPointe

CMS is planning to expand a value-based purchasing model that rewards home health agencies for high-quality care and saves Medicare money. The federal agency announced on Jan. 8 via email that it...

CMS Recalculates Medicare Physician Fee Schedule Rates for 2021

by Jacqueline LaPointe

CMS has updated Medicare Physician Fee Schedule rates for 2021 after a COVID-19 stimulus package mitigated budget neutrality cuts finalized in a December rule. The Consolidated Appropriations Act,...

HHS Renews Public Health Emergency, Regulatory Flexibilities

by Jacqueline LaPointe

HHS has renewed the COVID-19 public health emergency, extending key regulatory flexibilities such as Medicare telehealth reimbursement and higher rates for COVID-19 hospitalizations through April. The...

Underserved Areas Get Higher CARES Act Provider Relief Payments

by Emily Sokol, MPH

At the start of the COVID-19 pandemic, the healthcare industry was confused, scrambling, and scared. Patients did not know when and where it was safe to seek care and providers were overwhelmed with patients needing care for a disease they...

HHS Guidance Clarifies Use of Contract Pharmacies in 340B Program

by Jacqueline LaPointe

New guidance from HHS has clarified that hospitals and other covered entities in the 340B Drug Pricing Program are entitled to discounts for covered outpatient drugs even if they use contract...

Appeals Court Throws Out Hospital Price Transparency Challenge

by Jacqueline LaPointe

A federal appeals court has recently rejected the hospital industry’s challenge of the upcoming hospital price transparency rule that will require hospitals to disclose payer-specific rates to...