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SCOTUS just sided with hospitals over $4B in Medicare payments

June 4, 2019


The Supreme Court in a 7-1 decision has upheld a lower court ruling that CMS improperly changed Medicare's disproportionate-share hospital payment formula.

How CMS' new exact match policy could put hospital payments at risk

June 3, 2019


Hospitals have about one month to ensure their off-campus and outpatient facilities' addresses exactly match what CMS has on file or risk missing out on Medicare payments.

Are high hospital salaries really kickbacks? DOJ is bringing lawsuits to crack down.

June 3, 2019


Hospitals increasingly are offering high salaries to specialists whose businesses are big referral generators, but the federal government is heightening its scrutiny of these practices—and recently has brought several suits that allege these arrangements count as kickbacks.

HHS proposal would rescind Obama-era protections for transgender individuals

May 28, 2019


HHS on Friday issued a proposed rule that would roll back a regulation issued under former President Barack Obama's administration that prohibits health care providers and insurance companies from discriminating against transgender individuals.

How would single-payer impact health care costs and quality? It's not clear, CBO says.

May 24, 2019


Congressional Budget Office officials this week told House Budget Committee members that there currently are too many unknowns surrounding a single-payer health care system to determine how such a system would affect insurance rates and government spending, but any transition to single-payer would be "complicated."

Inside the 'ambitious' Alexander-Murray proposal to combat 'surprise' medical bills, lower drug costs

May 24, 2019


Senate Health, Education, Labor, and Pensions Committee Chair Lamar Alexander (R-Tenn.) and Sen. Patty Murray (D-Wash.), the committee's ranking member, on Thursday unveiled bipartisan draft legislation that aims to address so-called "surprise" medical bills and lower prescription drug costs in the United States.

CMS postpones CAR T-cell therapy coverage decision

May 20, 2019


CMS on Friday announced it is postponing a final policy decision that will outline how Medicare will cover CAR T-cell immunotherapies nationwide.

CMS cracks down on 'spread pricing' in Medicaid

May 17, 2019


CMS on Wednesday released regulatory guidance intended to clarify how state Medicaid programs should account for so-called "spread pricing" when calculating their medical loss ratios.

How senators want to stop 'surprise' medical bills

May 16, 2019


Lawmakers on the Senate Health, Education, Labor, and Pensions Committee on Thursday released a bipartisan draft bill to address so-called "surprise" medical bills by using an arbitration process to settle disputes over medical charges between providers and insurers—a proposal the White House has said it opposes.

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