CMS seeks to roll back Medicaid rule it says is burdensome to states
Robert King | Jul 11, 2019 The Centers for Medicare & Medicaid Services is seeking to roll back Obama-era rule on Medicaid payment rates that the agency says is outdated. The Trump administration proposed rolling back a 2015 rule that requires states to document whether Medicaid fee-for-service payment rates were enough. The Centers for Medicare…
Medicare outpatient claims-processing changes delayed till October: 5 things to know
Kelly Gooch | July 2, 2019 CMS has delayed for three additional months full implementation of Medicare outpatient prospective payment system claims edits for services provided by departments of hospitals and health systems. Five things to know: The system edits apply to providers with off-campus, outpatient, provider-based departments. They require Medicare outpatient service providers to…
ACA insurers remain profitable despite policy changes
Samantha Liss | July 1, 2019 Insurers selling individual plans continue to remain profitable despite policy changes that threatened to undermine the Affordable Care Act marketplaces, according to a recent report from the Kaiser Family Foundation. An analysis of insurers’ first quarter performance in 2019 found carriers continued to remain profitable on average. Premiums also fell slightly…
Trump order to force hospitals to reveal information behind negotiated rates
June 24, 2019 Dive Brief: Hospitals will be required to make public information based on their negotiated rates with insurers and both providers and payers will be ordered to give patients estimates for out-of-pockets costs for procedures in advance under an executive order President Donald Trump is expected to sign Monday. The order will direct…
Rural Health Appropriations Update
Mason Zeagler | June 21st 2019 This week, Congress has focused on finalizing debates regarding FY20 appropriations, and NRHA is proud to report that both chambers are seeking to include funds for a variety of necessary rural health programs in their legislation. Here are the highlights: • The newest version of the Senate HELP Committee’s…