Healthcare Business News

Plans Banned by ACA Can Continue into 2017

Mar. 6—The Obama administration has extended its one-year suspended enforcement against individual market health insurance plans that violate requirements of the 2010 healthcare overhaul.

FY14 DSH Allotments Issued

Mar. 5—Preliminary state allotments of FY14 Medicaid disproportionate share hospital (DSH) payments were recently issued by the U.S. Department of Health and Human Services.

Study: Wide Variation in Hospitals’ Antibiotic Use

Mar. 5—Hospital antibiotic use varied threefold between facilities examined in a recent study, and such disparities could have major ramifications for the health of patients.

Analysis: As Few as 2.4 Million Added to Medicaid

Mar. 4—Healthcare reform may have added as few as 2.4 million new enrollees to Medicaid, a new analysis found.

Obama Proposes $3.5 Billion in Medicare Provider Cuts

Mar. 4—Medicare would reduce payments to providers by nearly $3.5 billion under President Barack Obama’s FY15 budget, released Tuesday.

CMS Orders Review of Claims Denied Under 2-Midnight Rule

Mar. 3—Medicare auditors were ordered to re-review any “probe and educate” audits that led them to reject hospitals’ claims during the phased-in enforcement of Medicare’s two-midnight rule.

ACA Subsidies Offered Outside Exchanges

Feb. 28—The Obama administration extended both premium and out-of-pocket subsidies for the first time to people who buy health insurance coverage outside the exchanges.

Stage 2 EHR Penalty Waivers Offered

Feb. 28—Providers unable to find electronic health record (EHR) upgrades that meet 2014 federal requirements will not face penalties in 2015, due to a new hardship exemption.

Concerns Continue Regarding Latest Marketplace Enrollment Numbers

Feb. 27—The revelation this week that 4 million people have signed up for private insurance coverage through the Affordable Care Act (ACA) failed to resolve lingering healthcare industry concerns about enrollment shortfalls.

Vermont Initiative Cuts Costs, Hospital Revenue

Feb. 27—A statewide initiative to overhaul care delivery in Vermont has cut the cost of care for participating patients, but also has cut into the bottom lines of the state’s hospitals.

Bills Target CAH Discharge Requirement

Feb. 26—New legislation would block a long-unenforced Medicare discharge requirement for critical access hospitals (CAHs) amid signs that regulators will begin enforcing it.

Hospitals Paid $163 Million to Resolve Fraud Allegations in FY13

Feb. 26—Hospitals and health systems paid $163.4 million to settle healthcare fraud allegations in FY13, the Office of Inspector General (OIG) reported this week.

Study: More For-Profit Hospices Exceed Medicare Caps

Feb. 25—For-profit hospices were much more likely to exceed Medicare payment caps and they did so at a much higher rate than previously found.

AHA: 40 Percent of Hospitals May Not Meet 2014 Meaningful Use Requirements

Feb. 24—Up to two-fifths of hospitals are in danger of failing to meet 2014 federal requirements for demonstrating meaningful use of electronic health records, according to a leading hospital advocacy group.

Medicare Advantage Payment Rates to Decrease in 2015

Feb. 24—Medicare plans a 1.9 percent cut in 2015 for private plans that cover a growing share of its beneficiaries.

Quality Measures Added to Physician Compare

Feb. 21—A Medicare physician information website has added data on adherence to five quality measures by some physician groups, federal officials announced on Friday.

CMS Agrees to ICD-10 End-to-End Testing

Feb. 21—The Centers for Medicare & Medicaid Services will conduct some end-to-end testing of the new provider codes mandated for widespread adoption in the fall, the agency announced this week.

OIG: Add Hospital Services to Lump-Sum Payment

Feb. 20—Medicare should lump more services into its standard inpatient payments, a federal watchdog agency recommended this week.

Part D Changes Draw Healthcare Industry Fire

Feb. 19—Some healthcare advocacy groups this week urged the Obama administration to reverse proposed changes to Medicare’s Part D program that recent analyses concluded could cut coverage and increase beneficiary costs.

Study: Providers Have Most Compromised IT

Feb. 19—Providers, including hospitals and health systems, were the source of the vast majority of compromised health IT data found in a recent study.

Analysis: ACA Enrollment to Fall Short

Feb. 18—Enrollment through public health insurance exchanges and Medicaid authorized by the 2010 healthcare overhaul will fall far short of its 16 million-enrollee goal, according to 2014 projections from a national healthcare consulting firm.

Study Identifies Top Five ED Value Targets

Feb. 18—Imaging procedures dominated a top-five list of emergency medicine procedures that a new study found to have the lowest value and that offer the greatest potential to reduce healthcare costs.

CMS Clarifies Insurance Assistance Rules

Feb. 14—Healthcare foundations can pay for coverage by insurance plans offered on new government-run marketplaces, according to recent federal guidance.

Congress Extends Medicare Sequester Cuts to 2024

Feb. 13—Congress cleared legislation Wednesday to add another year to the ongoing 2 percent cut to Medicare providers and insurers, known as the sequester.

Marketplaces Enroll 3.3 Million in Four Months

Feb. 13—Enrollments in private health insurance plans offered through government-run marketplaces accelerated in January to bring total signups to nearly 3.3 million, federal officials announced this week.