News Briefs: Supreme Court ruling on Chevron makes regulations more vulnerable to legal challenges
The Supreme Court issued a decision June 28 that has dramatic implications for the regulatory infrastructure in healthcare, among many other industries. Under the Supreme Court’s 1984 Chevron v. Natural Resources Defense Council decision, courts were guided to give deference in their rulings to federal regulatory authorities such as CMS. Such agencies were deemed to…
Appeals court eliminates Medicare supplemental payments for low-wage hospitals (updated-2)
Note: This article was updated most recently Oct. 4 with news that CMS has ended the low-wage-index policy. See that update below. Plaintiff hospitals won litigation last week at the federal appellate level that will adversely affect Medicare payment for some rural hospitals. The U.S. Court of Appeals for the D.C. Circuit backed a district…
Medicare’s proposed 2025 rule for physician payments would add to the financial strain facing practices
Medicare’s proposed update to physician payments for 2025 left advocates saying practices will have an increasingly difficult time making ends meet. CMS’s newly proposed rule states that payments are set to be reduced by 2.8% from 2024, based on the change to the conversion factor. The agency explained that it is obligated to implement the…
A proposed Medicare condition of participation would bring a slew of new requirements for OB care
Note: HFMA’s coverage of the payment update in the outpatient payment proposed rule can be found here. Hospitals intending to participate in Medicare must meet new standards for obstetric (OB) care, according to CMS’s proposed outpatient rule for 2025. The rule proposes to establish a new Medicare condition of participation (CoP), whereby hospitals and critical…
Healthcare providers face Medicare payment-rate penalties for information blocking under new rule
Healthcare providers will receive a lower Medicare payment update if they are deemed to have engaged in information blocking, according to a final rule from HHS and CMS. For hospitals, a violation will leave the organization noncompliant with the Promoting Interoperability Program, meaning it would lose out on three-quarters of the annual market-basket update for…
Supreme Court ruling on Chevron makes regulations in healthcare (and other industries) more vulnerable to legal challenges
The U.S. Supreme Court issued a decision Friday that has dramatic implications for the regulatory infrastructure in healthcare, among many other industries. Since it was established in a 1984 case, Chevron deference has served as guidance to courts that regulatory authorities such as CMS and dozens of others across the federal government have license to…
Preventive-services coverage mandate for Affordable Care Act plans remains intact following appeals court ruling
In a decision that could have been consequential for health insurance coverage offered through the Affordable Care Act (ACA) marketplaces, an appeals court limited the immediate impact. The U.S. Court of Appeals for the Fifth Circuit upheld a lower-court ruling that preventive-care mandates for ACA health plans are unconstitutional. But the appeals court said the…
Congress seeks to keep the momentum going on improvements to prior authorization
Members of Congress are revitalizing efforts to pass legislation that would streamline prior authorization in Medicare Advantage (MA). A bipartisan, bicameral group of legislators reintroduced the Improving Seniors’ Timely Access to Care Act, a bill that unanimously passed the House in September 2022 but did not receive a vote in the Senate. One obstacle at…
Hospitals can bring their case on disproportionate share hospital payments to the Supreme Court
The Supreme Court granted hospitals’ request that it hear their appeal about the formula for determining Medicare disproportionate share hospital (DSH) payments, landing the case on the docket for the 2024-25 term. More than 200 hospitals are plaintiffs in the case. A federal district court ruled for HHS and against the hospitals in 2022, and…
Health system CEO tells Congress proposed 340B changes would be harmful to organizations like his
A health system executive visited Capitol Hill recently to provide the hospital perspective on the 340B Drug Pricing Program — a viewpoint that increasingly is coming under fire among policymakers. Matthew Perry, president and CEO of Genesis HealthCare System in Zanesville, Ohio, appeared at a House subcommittee hearing June 4 to give insight on why…