Questions loom over the future of telehealth policy
Federal telehealth policy continues to prove confounding for healthcare providers. The recent 43-day government shutdown marked the first extended period since the early days of the COVID-19 pandemic that traditional restrictions on telehealth reimbursement were in place. Medicare waivers of those restrictions helped telehealth utilization surge during the pandemic and remain elevated in the years…
At the 11th hour, an Affordable Care Act subsidy accord remains elusive (updated Dec. 12)
Dec. 12 update House Republican leaders plan to hold a vote this coming week on legislation to address healthcare costs. The bill does not include an extension of the Affordable Care Act (ACA) enhanced subsidies, which are set to expire at year’s end. As a nod to moderates in the party who have pushed for…
Hospitals hope litigation will stop the 340B rebate model before it gets started
Hospitals are going to court in an effort to thwart major changes to the 340B Drug Pricing Program. The American Hospital Association (AHA) was among a group that filed a lawsuit against the federal government Dec. 1, seeking to have implementation of a planned 340B rebate model halted before it begins Jan. 1. Under the…
CMS’s latest transparency rule aims to make price estimates more specific
Hospitals face additional and potentially more demanding price transparency reporting requirements in 2026, as finalized in new CMS regulations. The final rule for hospital outpatient departments and ambulatory surgical centers includes provisions building off the current transparency regulations. The new language is intended to ensure that hospitals “provide meaningful, accurate information about the amount they…
2026 Medicare final rule postpones a significant payment cut for hospitals
While implementing several policies that could constrain hospital finances next year and beyond, CMS offered temporary relief on one count. The Medicare 2026 final rule for hospital outpatient departments and ambulatory surgical centers (ASCs) was proposed to include an across-the-board 2% cut to base payments. But CMS, acknowledging the concerns of hospitals, kept the scheduled…
Senate hearing doesn’t resolve 2026 funding for Affordable Care Act marketplace plans
Senate Republicans used a recent hearing to press their case for enacting immediate reforms to part of the Affordable Care Act (ACA), with little sign they will agree to extend the subsidy framework that has been in place for more than four years. During the Nov. 19 hearing of the Senate Finance Committee, members of…
CMS gives new guidance on upcoming restrictions to Medicaid provider taxes
CMS issued preliminary guidance about how it will implement new restrictions on Medicaid provider taxes as required by the budget reconciliation law known as the One Big Beautiful Bill Act (OBBBA). OBBBA language will curb provider taxes as a Medicaid funding mechanism through which states can increase their allotment of federal matching dollars that, in…
Economic trends affect patient volumes at two large health systems
Macroeconomic factors are causing a moderate drop in demand for healthcare services, according to insights from executives with a pair of leading for-profit hospital chains. At Community Health Systems (CHS), the first quarter of 2025 brought strong hospital volumes, but those dipped during the middle part of the year. Same-store adjusted admissions were 0.7% lower…
Aetna delays and modifies new policy that’s set to hit reimbursement for inpatient hospital stays
Hospitals received a brief reprieve from a pending Aetna payment policy that remains likely to decrease reimbursement starting in 2026. In a prior announcement, Aetna said it would apply level-of-severity criteria to all urgent or emergent hospital admissions lasting at least one midnight for Medicare Advantage (MA) and Medicare Special Needs Plans patients. For stays…
Government funding deal would extend key healthcare programs but not Affordable Care Act enhanced subsidies
Note: This article has been updated with additional comments from members of Congress. Important healthcare funding could be restored in a matter of days, with an agreement to end the government shutdown now in sight. The Senate struck a deal Nov. 9 to advance a federal funding bill for a formal vote, with eight Democrats…