On Monday, June 24th, 2019, the Trump Administration will enact an executive order on the transparency of healthcare pricing. Within the order, healthcare providers and insurers will be required to disclose information about their negotiated rates and discounts. Through the Outpatient Prospective Payment System (OPPS) rule, federal agencies will be required start the regulatory process [...]
According to a new rule issued on Thursday by the Trump Administration, employers will be allowed to fund individual health plans for their workers. Previously, employers were allowed to fund health reimbursement accounts (HRAs) for workers to receive reimbursement for out-of-pocket medical expenses, but through this new rule, those HRAs can be used to purchase [...]
As the Centers for Medicare & Medicaid Services (CMS) continue their initiative to move healthcare towards a value-based care system, which is a form of reimbursement that ties payments for care delivery to the quality of care provided and rewards providers for both efficiency and effectiveness, one particular regulation stands in their way - the [...]
According to a report from the Kaiser Family Foundation, insurers who participate in selling health insurance plans in the Affordable Care Act (ACA) markets have collected more premiums than needed. The report estimates that insurers have collected an excess of $800 million in premiums and are expected to give these premiums back to consumers as [...]
A growing number of physician practices are relying on private equity firms for investments, more than entrusting in hospital systems and larger physician organizations. Private equity firms are investing in physician practices specializing in certain profitable specialties, such as orthopedics, urology and gastroenterology. As certain compliance requirements have increased while reimbursement has decreased, physicians practices [...]
The Trump Administration had ordered the Justice Department to abolish the Affordable Care Act (ACA), which had been enacted nine years ago under the Obama Administration. The House of Representatives voted on Wednesday to stop the Justice Department from carrying out the ACA termination, with the final tally set at 240 to 186, counting eight [...]
On Thursday, a U.S. District Judge ruled against the Trump administration's efforts to expand on association health plan rules. The Trump administration had developed a final rule that allows for association health plans to be developed by associations and employers, which the judge has ruled that it is beyond the Trump administration's authority under the [...]
On Thursday, the Centers for Medicare and Medicaid Services (CMS) made the announcement that the number of providers who participate in the Bundled Payments for Care Improvement (BCPI) Advanced model has decreased by 16%, scaling down to 1,086 providers from 1,299 providers. The BCPI Advanced model was initially started in October 2018 as the first [...]
The Centers for Medicare and Medicaid Services (CMS) has been working to continually evolve and reform the Accountable Care Organizations (ACOs) program. A recent reform to the ACO program was the Pathways to Success Rule, which was enacted in late 2018, which focused on reforming the Medicare Shared Savings Program (MSSP). The Pathways to Success [...]
After having received over 300 comments on recommended modifications to the Stark law, the Centers for Medicare and Medicaid Services (CMS) decided to make major changes to the federal law. CMS Administrator Seema Verma announced part of the big improvement to the Stark law on Monday, stating that the CMS will a major part will [...]