On Thursday, judges from the U.S. Court of Appeals for the Federal Circuit raised their concerns that insurers were overly compensated from the subsidies received from the government is giving them, which were given due to the losses from cost-sharing reduction payments. In October 2017, the cost-sharing reduction payments were cut from insurers, and was originally [...]
The Centers for Medicare and Medicaid Services (CMS) are pushing to change Stark law statutes to facilitate providers to be in value-based contracts without the concern of being blamed for kickbacks. The Stark law, which is the anti-kickback and self-referral laws, aid more value-based payments and coordinated care, while preventing physicians from benefiting and profiting [...]
After months of debate over surprise billing and how to protect patients from out-of-network charges, lawmakers were not able to come to a compromise on the surprise billing proposal, failing to get the bill included in the 2019 year-end spending deal. The spending deal was an opportunity for the surprise billing legislation to be passed. [...]
On Thursday, the U.S. Senate passed a spending bill that repeals three ACA taxes as well as postpones Medicaid payment cuts. The spending bill was voted for approval 71 - 23 in the Senate. The President is set to sign off on the spending bill to prevent a federal government shutdown. The spending bill also [...]
On Tuesday, the United States Supreme Court heard a lawsuit pertaining to unpaid risk corridor payments ranging from 2014 to 2016. Risk corridor payments are a component of the Affordable Care Act that limits the risk from qualified health plans on the insurance marketplaces that work to minimize year-end losses of insurers who cover older, [...]
According to the statistics from the Centers for Medicare and Medicaid Services, open enrollment signups is still growing, but is not as substantial as previous years' enrollment. Currently, it is Week 3 of open enrollment, which officially began on November 1, 2019, and the enrollment count is down by 13% compared to last year's numbers. [...]
According to a recent federal research study, Medicare beneficiaries are feeling the cost burden that is resulting from the consolidation of hospital systems and independent physician practices. These enrollees are paying more for their healthcare, as the hospital-physician systems are raising prices for insurers. Health systems are actively pursuing purchasing physician practices to integrate into [...]
Health insurance plans in the Affordable Care Act (ACA) exchange will experience a decline in premiums in 2020 although the health insurance marketplace will offer more plan choices. This will be the second year running that health insurance premiums on the ACA exchange will have a decrease. The marketplace is going to get larger, with [...]
The Centers for Medicare and Medicaid Services have reported savings from their Medicare Shared Savings Program. According to new agency data, the CMS has retained a savings amount totaling $739.4 million in 2018. Compared to 2017, the CMS only saved a total of $314 million from the Medicare Shared Savings Program. Although more ACOs had [...]
As hospitals around the nation are shifting from fee-for-service to value based care, hospitals are also looking to revitalize their hospital board. As the industry is getting on board with major changes and improvements, such as the focus on population health and alternative payment models, the hospital board needs to provide better insight and advice [...]