Dr. Oz and CMS, plus HFMA’s new Fast Finance newsletter
Nick Hut and Shawn Stack discuss the confirmation hearing of Mehmet Oz as CMS administrator. Also in this episode, HFMA’s Brad Dennison and Rich Daly talk about the new Fast Finance newsletter. To sign up for the newsletter, email Brad Dennison at [email protected].
Hospital financial metrics suggest need for added Medicare payment, MedPAC says
Hospital metrics suggest FY26 Medicare payment should increase by more than what’s provided in the statutory formula, according to a formal recommendation by the Medicare Payment and Advisory Commission (MedPAC). Beneficiary access to care appeared to be strong in 2023, the latest year for which data was available, but quality indicators were mixed, according to…
Trump administration keeps up the fight on 340B, Inflation Reduction Act concerns
The issue of drug pricing is proving to be an area of harmony and continuity between the Trump and Biden administrations, at least for now. In recent days, the Trump administration moved to defend the Biden administration’s stance in opposition to drug manufacturers that are looking to offer 340B Drug Pricing Program discounts through a…
Trump administration charts a new course at the Center for Medicare & Medicaid Innovation
The Trump administration has started to streamline the portfolio of alternative payment models sponsored by the Center for Medicare & Medicaid Innovation (CMMI), recently announcing the early expiration of four models. CMS said the decision resulted from an assessment of whether the models could meet statutory criteria to be expanded into the full Medicare program.…
Dr. Oz describes changes he would bring to Medicare, Medicaid as CMS administrator
April 3 update: The Senate formally confirmed Oz as CMS administrator via a 53-45 party-line vote. He is expected to be sworn in and begin work within days. March 25 update: The Senate Finance Committee voted 14-13 along party lines to send Oz’s nomination to the full Senate for a formal confirmation vote. Democrats voting…
Affordable Care Act marketplace enrollment likely to decrease under proposed regulations
The Trump administration’s first regulations on the Affordable Care Act health insurance marketplaces are projected to reduce enrollment. As announced by CMS on March 10, a soon-to-be-published proposed rule would implement new program integrity standards for the marketplaces. Part of the motivation stated in the rule is to address “a substantial risk of improper enrollment.”…
Medicaid DSH payment cut again delayed in proposed federal funding bill (updated)
March 15 update: The bill has passed both chambers of Congress as originally drafted and described below. Hospitals that receive Medicaid disproportionate share hospital (DSH) payments would get continued relief from a pending big cut, according to the latest proposed FY25 continuing resolution (CR). A scheduled three-year, $24 billion reduction would be delayed through September…
MedPAC March 2025 Public Meeting Summary
HFMA presents a detailed summary of the March 6-7, 2025, MedPAC public meeting.
Injunction granted on policy change that would hamper funding for teaching hospitals
A federal judge has extended a block on a Trump administration policy that would cap reimbursement for indirect medical research costs at institutions such as teaching hospitals. Per the Feb. 7 policy issued by the National Institutes of Health (NIH), add-on payments for facility and administrative expenses as part of research grants would be limited…
Going their own way: Numerous hospitals opt out of Blues settlement
Several large health systems and dozens of other hospitals and healthcare providers are pursuing antitrust litigation against Blue Cross Blue Shield (BCBS) after opting out of a record-setting settlement. Lawsuits are known to have been filed against the insurer in California, Illinois and Pennsylvania federal court since March 4, the deadline for hospitals to opt…