No Surprises Act arbitration may raise premiums and healthcare costs, CBO says
The Congressional Budget Office (CBO) may need to rethink its original projection that the No Surprises Act would save money for the federal government, the agency said this week in a recommendation for additional research on the issue. In 2021, the CBO estimated that the newly signed law would lower provider payments, especially out-of-network rates,…
HFMA Comments on the FY 2027 Hospital IPPS and LTCH Proposed Rule
HFMA comments on CMS’s FY 2027 Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Proposed Rule.
Annual Conference 2026, Day 4: The healthcare policy outlook is sluggish heading into the midterms
Wednesday video recap: AC26 Closing Recap: Thank You, National Harbor Included in this roundup: The healthcare policy outlook is sluggish heading into the midterms CMS official gives a primer on access Succeeding under value-based care Life lessons from a Hall of Famer See you next year At a time when care delivery pressures are intensifying,…
Annual Conference 2026, Day 3: Mehmet Oz tells attendees how ongoing improvements will bolster healthcare system sustainability
Tuesday video recap: AC26 Day 3 Recap: What’s Next for Healthcare Finance In this roundup: Mehmet Oz tells attendees how improvements will bolster the sustainability of the healthcare system Hospital strategies that don’t have a strong track record Natural disasters represent another stumbling block for hospitals Planning should be underway for responding to the OBBBA…
OBBBA Medicaid cuts increase credit risk for NFP hospitals
Looming healthcare cuts as legislated in the One Big Beautiful Bill Act (OBBBA) constitute the biggest risk to the not-for-profit (NFP) hospital industry, according to insights from experts with the leading credit-rating agencies. The OBBBA is set to hit Medicaid over the next few years, bringing potentially sizable reductions to enrollment along with direct cuts…
Medicaid work requirement rule adds significant wrinkles to program eligibility criteria
For state agencies and potentially healthcare providers, CMS’s regulatory guidance on implementing the Medicaid work requirement imposes responsibilities that go beyond language seen in the underlying statute. CMS published an interim final rule with comment period late Monday, just barely meeting the June 1 deadline established in the 2025 reconciliation law known as the One…
Medicaid revenue cutbacks, plus the healthcare fraud landscape
Nick Hut is joined by HFMA Policy Director Katie Gilfillan to discuss fraud, waste and abuse as well as state-directed Medicaid payments. Further reading: CMS Medicaid state-directed payment rule | HFMA
Medicaid Managed Care State Directed Payments and FFS Targeted Medicaid Practitioner Payments Proposed Rule Summary
HFMA provides a detailed summary of the rule that includes proposals to implement the provisions of the “Working Families Tax Cut” legislation, which modify the limit on the total payment rate and other requirements for State directed payments (SDPs) in Medicaid managed care with respect to certain service types and SDPs, and the proposals to expand application of the modified limit to all SDPs and all service types and to set a limit for certain targeted Medicaid payments in Medicaid fee-for-service.
Final rule lowers No Surprises Act IDR fees, adds requirements
Regulations issued Thursday to update the No Surprises Act’s independent dispute resolution (IDR) process represent an effort to improve access while also streamlining the volume of cases. CMS and the Departments of Labor and Treasury published a final rule that significantly lowers IDR fees but includes more requirements of the insurers and providers that seek to use…
News Briefs: CMS proposes a modest increase to hospital inpatient payments for FY27
CMS projects an average Medicare inpatient payment increase of 2.4%, totaling $1.4 billion industrywide, when the new fiscal year begins Oct. 1. The update, described in a proposed rule for inpatient care and long-term care hospitals (LTCHs), is based on a 3.2% increase to the market basket and a 0.8% reduction via a mandatory economywide productivity adjustment.…