Continued 340B eligibility is at risk for hundreds of hospitals thanks to pandemic-related factors
Hospitals that rely on savings from the 340B Drug Pricing Program should examine the possibility that they’ll soon be rendered ineligible. Several factors are having an industrywide impact on the disproportionate share hospital (DSH) adjustment percentage, and if that tally drops below a certain threshold on a hospital’s Medicare cost report, the hospital cannot receive…
New data on national healthcare spending highlights the constraints facing hospitals
Recently published 2022 data indicates relatively restrained national healthcare spending as the COVID-19 pandemic faded, especially in the hospital sector. The increase in spending on hospital services slowed from 4.5% in 2021 to 2.2% in 2022, CMS actuaries reported Dec. 13 in Health Affairs. The increase was significantly less than in 2020 (6.2%) and the…
With a new rule, CMS looks to crack down on states’ Medicaid disenrollment processes
In its latest effort to stem the ongoing wave of Medicaid disenrollments, CMS issued regulations describing its authority to penalize states for disregarding federal guidelines pertaining to the end of continuous-enrollment requirements. Published Dec. 6 in an interim final rule with comment period, the regulations took effect immediately and were based on provisions passed by…
Medicare’s final $9 billion remedy plan for 340B providers doesn’t address hospitals’ key concerns
Hospitals received final details on a $9 billion remedy payment plan for participants in the 340B Drug Pricing Program, with advocates expressing disappointment that corresponding reductions to other payments will go through as previously proposed. CMS issued a Nov. 2 final rule describing the terms of the remedy payment, which was necessitated after the Supreme…
HRSA curtails pandemic-era 340B flexibilities for hospitals’ off-campus outpatient facilities
In an expected move that stands to affect the savings reaped by health systems from the 340B Drug Pricing Program, the Health Resources and Services Administration (HRSA) is tightening participation requirements for off-campus outpatient facilities. In a published alert, HRSA announced plans to end pandemic-related flexibilities that have made it easier for off-campus outpatient facilities…
Published data quantify how cost increases will continue to affect the healthcare industry next year
The cost to treat patients will accelerate next year, with ramifications across the healthcare industry, according to newly published projections. PwC’s Health Research Institute reported that the cost of providing care will increase by 7% in 2024, up from a 6% increase this year and 5.5% in 2022. A 7% increase would tie 2021 for…
Money received through the Provider Relief Fund could be at risk as audits ramp up
Recipients of Provider Relief Fund (PRF) distributions and COVID-19 Uninsured Program payments should be girding themselves for audits, legal experts say. The programs represent “a two-front audit fight that providers are facing and will face in the coming years,” Brian Lee, partner with Alston & Bird, said during an Aug. 24 webinar hosted by the…
As anticipated, the start of the Medicaid unwinding process has taken a toll on coverage
Fears among healthcare policymakers that the end of the COVID-19 public health emergency would sow chaos in Medicaid have been realized, leading the Biden administration to intensify its mitigation efforts. The end of Medicaid continuous-enrollment provisions is affecting the program in many states. In 21 states that had begun the “unwinding” process since April 1,…
News Briefs: The expiration of the COVID-19 PHE brings an end to key provisions
The termination of the COVID-19 public health emergency (PHE) on May 11 meant providers lost many of the accommodations and regulatory flexibilities that were in place since Jan. 31, 2020. For example, Medicare’s 20% add-on payment for treating COVID-19 cases in the inpatient setting no longer is available. With reported cases and hospitalizations steadily trending…
The COVID-19 public health emergency is over: Here’s what healthcare providers should know
An era ends for the U.S. healthcare industry with the termination of the COVID-19 public health emergency (PHE) at the close of the day on Thursday, May 11. The termination means providers are losing many of the federal waivers and flexibilities that have been in place for all or most of the PHE, which took…