Medicare Drug Price Negotiation Program Proposed Rule Summary
HFMA provides a detailed summary of the proposed rule to codify the Medicare Drug Price Negotiation Program (“Negotiation Program”) and establish certain new policies for the Negotiation Program and the Medicare Prescription Drug Benefit Program as required by the Inflation Reduction Act of 2022 (IRA, P.L. 117-169).
Medicare funding projections sharpen concerns over access and payment rates
The latest annual report on the state of Medicare funding reflects a conundrum for healthcare industry stakeholders. Medicare spending on healthcare services is on an increasingly difficult fiscal track, projected to rise from $1.2 trillion in 2025 to $2 trillion in 2035. Yet as acknowledged in the report issued this month by the Medicare trustees,…
FY27 HHS budget proposal includes rural health gains, CDC cuts
HHS discretionary funding in FY27 would decrease by close to 4% from current appropriations, according to a budget proposal that advanced out of the House Appropriations Committee this month. The $110.8 billion allocation would be roughly $4 billion lower than FY26 enacted funding. The budget appears to preserve more funding for traditional programs, relative to…
DOJ’s OhioHealth antitrust settlement affects payer contracts
The U.S. Department of Justice and OhioHealth have settled antitrust litigation that hinged on allegations concerning the health system’s contracting practices. A June 16 filing with the Southern District of Ohio federal court states that the parties, which also include the state of Ohio, reached a consent decree in which OhioHealth does not admit wrongdoing…
No Surprises Act arbitration may raise premiums and healthcare costs, CBO says
The Congressional Budget Office (CBO) may need to rethink its original projection that the No Surprises Act would save money for the federal government, the agency said this week in a recommendation for additional research on the issue. In 2021, the CBO estimated that the newly signed law would lower provider payments, especially out-of-network rates,…
HFMA Comments on the FY 2027 Hospital IPPS and LTCH Proposed Rule
HFMA comments on CMS’s FY 2027 Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Proposed Rule.
Annual Conference 2026, Day 4: The healthcare policy outlook is sluggish heading into the midterms
Wednesday video recap: AC26 Closing Recap: Thank You, National Harbor Included in this roundup: The healthcare policy outlook is sluggish heading into the midterms CMS official gives a primer on access Succeeding under value-based care Life lessons from a Hall of Famer See you next year At a time when care delivery pressures are intensifying,…
Annual Conference 2026, Day 3: Mehmet Oz tells attendees how ongoing improvements will bolster healthcare system sustainability
Tuesday video recap: AC26 Day 3 Recap: What’s Next for Healthcare Finance In this roundup: Mehmet Oz tells attendees how improvements will bolster the sustainability of the healthcare system Hospital strategies that don’t have a strong track record Natural disasters represent another stumbling block for hospitals Planning should be underway for responding to the OBBBA…
OBBBA Medicaid cuts increase credit risk for NFP hospitals
Looming healthcare cuts as legislated in the One Big Beautiful Bill Act (OBBBA) constitute the biggest risk to the not-for-profit (NFP) hospital industry, according to insights from experts with the leading credit-rating agencies. The OBBBA is set to hit Medicaid over the next few years, bringing potentially sizable reductions to enrollment along with direct cuts…
Medicaid work requirement rule adds significant wrinkles to program eligibility criteria
For state agencies and potentially healthcare providers, CMS’s regulatory guidance on implementing the Medicaid work requirement imposes responsibilities that go beyond language seen in the underlying statute. CMS published an interim final rule with comment period late Monday, just barely meeting the June 1 deadline established in the 2025 reconciliation law known as the One…