Healthcare Reform

Definition of “Employer”—Association Health Plans Proposed Rule Summary

HFMA presents a detailed summary of the proposed rule published by the Employee Benefits Security Administration that would rescind the similarly titled rule finalized in 2018 (83 FR 28912) that expanded the regulatory definition of “employer” under the Employee Retirement Income Security Act of 1974.

HFMA January 3, 2024

Andrew Donahue: 4 reasons results of the 2024 election won’t matter for healthcare

There is a strange and underappreciated truth at the top of the American political system: Our president is remarkably powerless. Except in the realms of foreign policy, executive agency action and judicial branch appointments, the president’s policy agenda is rarely guided by intention. Rather, it is defined by limitation. Savvy presidents learn quickly that their…

Andrew Donahue, FHFMA, CPA October 27, 2023

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…

Nick Hut May 30, 2023

News Briefs: Medicare’s proposed FY24 update to inpatient payments falls short, hospitals say

Hospitals are less than pleased with Medicare’s proposed FY24 payment increase for inpatient care. In regulations released April 10, the net inpatient payment update is 2.8% after factoring in a mandatory productivity adjustment of -0.2 percentage points. As usual, the update would be reduced for any hospital that does not fulfill quality-reporting requirements or qualify…

Nick Hut April 28, 2023

Final rule for Affordable Care Act marketplace plans could expand contracting opportunities for certain types of providers in 2024

Final 2024 regulations for health plans participating in the Affordable Care Act (ACA) insurance marketplaces are designed to improve equitable access to behavioral healthcare, potentially meaning a wider array of providers will have a chance to be included in networks. As of 2023, a participating plan must have at least 35% of available essential community…

Nick Hut April 26, 2023

Court decision means cost sharing could be reinstated for some preventive healthcare services

Comprehensive coverage of some preventive care services could be jeopardized by a recent court ruling. Since its passage, the Affordable Care Act (ACA) had required health plans to cover the full cost of services that received an “A” or “B” rating from the U.S. Preventive Services Task Force (USPSTF). A federal judge in Texas ended…

Nick Hut April 2, 2023

2022 midterms aftermath: Gridlock or bipartisanship? 

Studies conducted over the past several years have found the polarization is increasing in American society.a And not surprisingly, the 2022 midterm elections reflected the deep divisions. Two fiercely contested Senate seats in this past election are emblematic. Democrat John Fetterman won Pennsylvania’s hotly contested Senate race over Republican Mehmet Oz, MD, taking over the seat…

Ken Perez February 28, 2023

Healthcare News of Note:  7 hospitals earn a Press Ganey award for outstanding nursing quality

Seven hospitals were recognized for elevating nursing excellence and improving patient outcomes with Press Ganey’s National Database of Nursing Quality Indicators Award for Outstanding Nursing Quality. Only 48% of Americans rank the quality of U.S. healthcare as excellent or good, according to results of a Gallup Health and Healthcare survey. Nearly half of Americans are…

Deborah Filipek February 20, 2023

A “spicy” lame duck session for the 117th Congress and other things to expect after midterm elections

Friend of the podcast Chad Mulvany of the California Hospital Association joins HFMA Policy Director Andrew Donohue and Senior Editor Nick Hut in a discussion about what midterm elections could mean for healthcare.

Erika Grotto December 19, 2022

Healthcare News of Note: Telehealth aids outcomes for Medicare beneficiaries with opioid-use disorder

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Medicare beneficiaries initiating new episodes of OUD-related care get benefits from telehealth use, changes to inventory management strategies are coming for many sectors, and HAIs hit community hospitals hardest during the pandemic.

Deborah Filipek September 12, 2022
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