Hospitals plan for OBBB rollout
Health system executives are scrambling to prepare their organizations for numerous health policy changes recently enacted as part of the budget reconciliation law. Hospital and health system executives are looking at a range of responses to the July 4 enactment of enacted One Big Beautiful Bill Act (OBBB). That law holds 10-year federal Medicaid spending…
Medicaid cuts to hit hospitals before OBBB Medicaid cuts
Hospitals and health systems are facing financial challenges due to a series of regulatory changes and lack of action in other areas, including $24 billion in Medicaid DSH cuts, $90 million in ACA marketplace navigator funding, and potential cuts to Medicaid and ACA marketplace subsidies.
Federal Medicaid cuts loom, but states can act sooner
States have the option to implement Medicaid cuts required by the One Big Beautiful Bill Act earlier than 2027, including work requirements, eligibility determination frequency, and retroactive coverage limitations, and may also target provider rates and social determinants of health programs.
Many hospitals offer financial aid to patients, but need to improve outreach
Hospitals are often not given credit for the discounts they offer patients, and patients should be encouraged to seek help.
Providers urged to leverage data and strategy for successful payer negotiations
Finance leaders at hospitals and health systems can improve their negotiations with payers by using data, leveraging their market share, starting early, aligning leadership, prioritizing contract language, and reaching decision makers.
Senate passes tax bill with $1 trillion in Medicaid cuts despite concerns
The Senate passed a tax and spending reduction bill that includes over $1 trillion in 10-year Medicaid cuts, with Vice President J.D. Vance breaking a 50-50 tie, and included amendments to create a $25 billion fund for rural hospitals and accelerate the start of new Medicaid eligibility checks to 2027.
340B reporting law enacted by sixth state
Maine has enacted legislation requiring hospitals to report 340B revenue and other data, and several states have enacted laws requiring hospitals to report 340B data, while a federal rule to cut in Medicare 340B payments has not yet been introduced.
Medicaid policy changes threaten financial boon for hospitals and health systems
Medicaid legislative changes, including proposed rate caps, work requirements, and limits on provider taxes, are expected to end the financial boon for hospitals and health systems, according to S&P Global Ratings.
CMS transparency update effective immediately
CMS has issued new sub-regulatory hospital price transparency guidance effective immediately, requiring hospitals to remove nine 9s as placeholder amounts from their machine-readable files and replace them with actual estimated allowed amounts, or risk facing enforcement actions.
Senate budget bill tightens Medicaid provider tax rules and limits payment rates
The Senate Finance Committee has introduced a new version of the budget reconciliation bill that would cut Medicaid more aggressively than the House-passed version, primarily through provider taxes and state-directed payments, which would result in lower limits for provider rates and a cap on future SDPs to Medicare rates.