Medicare Drug Price Negotiation Program Guidance
HFMA presents a summary of CMS proposed initial guidance memorandum pertaining to the Medicare Drug Price Negotiation Program.
Healthcare News of Note: Medicare to negotiate reduced prices for 40 drugs by 2028, says study
Medicare drug price negotiation has the potential to benefit Medicare beneficiaries across some of the most common disease states.
Highlights of the Administration’s FY 2024 Budget
HFMA presents a summary of healthcare-related proposals included in the President’s budget for fiscal year 2024, released by the Biden Administration on March 9, 2023.
Medicare DSH Adjustment and Section 1115 Waiver Days Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule published by CMS that would change the policies on how the Medicare disproportionate share adjustment is determined, relating to the counting of days associated with individuals eligible for certain benefits provided by section 1115 demonstrations.
News Briefs: Healthcare industry disrupter CVS Health to shell out billions to buy Oak Street Health
A month after stating it hoped to gain a presence in primary care, CVS Health accomplished that goal with a massive deal that could fortify its efforts to advance value-based payment in healthcare. The proposed $10.6 billion acquisition of Oak Street Health, a provider of senior-focused primary care, adds to a portfolio of assets that…
In new final rule, CMS looks to claw back billions in overpayments to Medicare Advantage health plans
CMS has confirmed a new approach to its auditing of payments directed to Medicare Advantage health plans, but the agency says the regulatory burden on providers should not increase. A newly published final rule on risk adjustment data validation (RADV) establishes that CMS will use an extrapolation methodology to recoup overpayments to MA plans beginning…
Healthcare News of Note: 100 hospitals receive funding for new physician residency slots to boost healthcare access
CMS distributed 200 Medicare-funded physician residency slots to 100 hospitals, aiming to bolster healthcare access in areas with a shortage of qualified professionals. Overall cancer mortality has dropped 33% since 1991, averting an estimated 3.8 million cancer deaths, according to the American Cancer Society’s latest report. Patients’ ratings of specialist care were markedly higher when…
News Briefs: 2023 brings a steep fee hike for No Surprises Act arbitration cases
The No Surprises Act’s independent dispute resolution (IDR) process has become more expensive for healthcare stakeholders. For the new year, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration increased from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and…
During a potentially tumultuous Congress, healthcare stakeholders should communicate their policy priorities
With the 118th Congress bringing the potential for policy upheaval, one of the best things healthcare stakeholders can do is make themselves heard on Capitol Hill. The new Republican majority in the House of Representatives has signaled its intent to use the federal debt ceiling as leverage in budget negotiations. President Joe Biden and the…
Key points to know in recently proposed rules for Medicare Advantage and the ACA marketplaces
A proposed rule for health plans in Medicare Advantage has provisions designed to stem overreach in prior authorization processes.