CMS released a proposed rule this week that would boost hospitals’ inpatient payment rates by 2.6%. Hospitals groups have swiftly denounced this plan, arguing that this payment update is insufficient and will jeopardize hospitals’ financial stability.
The aftermath the cyberattack on Change Healthcare remains messy, with patients across the country still struggling to obtain their prescriptions. The federal government has even stepped in to help address the fallout of the attack, urging payers to quickly alleviate the digital bottlenecks that providers and pharmacies are facing.
Pharmacies across the country are facing disruptions following a cyberattack on Change Healthcare — which is owned by Optum, a subsidiary of UnitedHealth Group. In a filing with the SEC, UnitedHealth stated that the unauthorized party that gained access to Change Healthcare's systems was a “suspected nation-state associated cyber security threat actor."
Establishing site-neutral payments for outpatient services is a hot issue in Capitol Hill right now. Advocates say that such policy would lower healthcare costs, saving both patients and taxpayers money. Opponents say that it would put hospitals’ financial security at risk and jeopardize access to care.
CMS finalized updates to its physician fee schedule for 2024, as well as finalized the rule for next year’s Outpatient Prospective Payment System (OPPS). Provider groups are displeased with the updated rules, arguing that both physicians and provider organizations need more monetary relief than what the agency is offering.
This week, senators introduced a bipartisan bill that would make it a federal crime to assault hospital workers. Even though nearly 40 states have passed laws to intensify penalties for violent acts committed against healthcare personnel, there is currently no federal law protecting hospital employees from assault or intimidation.
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
CMS released a proposed rule to establish staffing standards among the nation’s nursing homes. Reactions have been mixed — but mainly negative. Long-term care facilities say that they can neither find nor afford more workers. On the other hand, some lawmakers argue the proposed rule doesn’t do enough to protect care quality for patients. As for labor unions, they seem generally happy with the rule.
CMS recently revealed its proposals to raise reimbursement rates for hospital outpatient departments and cut payments for physicians. Next year, the agency is planning to decrease physicians’ pay by 1.25% and increase outpatient payment rates by 2.8%. Provider groups are unhappy with the news — AMA President Dr. Jesse Ehrenfeld said the new physician fee schedule will be “almost biblical in its impact.”
Of the more than 15% of American adults who have past-due medical debt, about 73% owe some or all of the money to hospitals, according to a recent Urban Institute report. The American Hospital Association said short-term limited duration health plans and high-deductible health plans are to blame.
Hospitals are struggling to discharge patients in a timely manner, according to the American Hospital Association. This is often because there are no available spots for patients being transferred to outpatient facilities. To remedy the increased costs hospitals face as a result of this issue, an AHA exec said Medicare should establish a temporary per diem payment for cases in which a patient is ready for discharge but is unable to be discharged appropriately.
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Less than 1% of hospitals and health systems said their relationship is improving and the rest said it has stayed the same. The American Hospital Association specifically called out commercial insurers for their practices on prior authorization and claims denials and delays.
AHA’s report comes after the U.S. House of Representatives passed the Improving Seniors’ Timely Access to Care Act, which would establish several requirements for the prior authorization process under MA plans. But AHA believes additional action is needed by the government.
The bill sets requirements relating to the prior authorization process for Medicare Advantage plans. The House's decision is supported by several healthcare advocacy organizations, including Better Medicare Alliance and the American Hospital Association. AHIP, however, neither criticized nor celebrated the passage.
The length of stay for adult inpatients is expected to rise by 8% over the next decade, driven by an increase in chronic conditions, according to a report released Tuesday by Vizient. The rise in acuity will exacerbate hospitals’ capacity constraints, so they may need to rethink their care delivery models and make investments in at-home care.
The American Hospital Association and Association of American Medical Colleges have filed an amicus brief in support of the New Jersey health systems that are appealing a court decision to delay their merger following a legal challenge from the FTC.
