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CMS’s move to cut Medicare payments made through the 340B drug discount programs would see the biggest impact in California, New York and North Carolina, according to an analysis by Avalere Health, though for most hospitals it will reduce their total Part B revenue by less than 5 percent.

The Affordable Care Act’s taxes on health insurance, high-cost health plans and medical devices would be delayed under a series of bills introduced by House Republicans, with the Medical Imaging & Technology Alliance (MITA) quickly coming out in support of suspending the device tax.

Two Senate Democrats have asked CMS and HHS to make a last-minute extension of the open enrollment period for the Affordable Care Act (ACA)’s insurance exchanges, arguing the Dec. 15 deadline will leave too many interested customers either without health coverage or automatically enrolled into plans which “may no longer be the best choice for their families.”

The repeal of the Affordable Care Act’s individual mandate has been projected to cause insurance premiums to rise by an average of 10 percent through 2027. Those hikes would be mitigated, however, if Congress funded the ACA’s cost-sharing reduction subsidies and a $10 billion, two-year reinsurance program, according to an analysis from Avalere.

The American Hospital Association (AHA) suggested the Medicare Payment Advisory Commission (MedPAC) pump the brakes on advocating for major changes to Merit-based Incentive Payment System (MIPS), saying any major shifts wouldn’t have “the benefit of data or experience” considering this is the program’s first performance year.

 

Recent Headlines

Which states would see the largest cuts due to 340B changes

CMS’s move to cut Medicare payments made through the 340B drug discount programs would see the biggest impact in California, New York and North Carolina, according to an analysis by Avalere Health, though for most hospitals it will reduce their total Part B revenue by less than 5 percent.

House Republicans introduce plan to delay ACA taxes

The Affordable Care Act’s taxes on health insurance, high-cost health plans and medical devices would be delayed under a series of bills introduced by House Republicans, with the Medical Imaging & Technology Alliance (MITA) quickly coming out in support of suspending the device tax.

Democrats ask for extension of ACA open enrollment

Two Senate Democrats have asked CMS and HHS to make a last-minute extension of the open enrollment period for the Affordable Care Act (ACA)’s insurance exchanges, arguing the Dec. 15 deadline will leave too many interested customers either without health coverage or automatically enrolled into plans which “may no longer be the best choice for their families.”

ACA funding bills would cancel out hikes from repealing individual mandate

The repeal of the Affordable Care Act’s individual mandate has been projected to cause insurance premiums to rise by an average of 10 percent through 2027. Those hikes would be mitigated, however, if Congress funded the ACA’s cost-sharing reduction subsidies and a $10 billion, two-year reinsurance program, according to an analysis from Avalere.

AHA to MedPAC: Eliminating, changing MIPS would confuse providers

The American Hospital Association (AHA) suggested the Medicare Payment Advisory Commission (MedPAC) pump the brakes on advocating for major changes to Merit-based Incentive Payment System (MIPS), saying any major shifts wouldn’t have “the benefit of data or experience” considering this is the program’s first performance year.

Major insurers’ reliance on Medicaid, Medicare revenues could be used to boost ACA participation

The largest health insurers—UnitedHealthcare, Aetna, Anthem, Cigna and Humana—are getting nearly 60 percent of their total combined revenue from Medicare and Medicaid plans, according to a Health Affairs study, with that money more than doubling since the Affordable Care Act (ACA) was passed.

CMS finalizes cancellation of mandatory bundles

In a final rule issued on Nov. 30, CMS finalized changes to several mandatory bundled payment programs, canceling two surrounding hip fractures and cardiac care and reducing requirements in a joint replacement bundle.

CBO: Funding CSRs won’t mitigate impact from repealing individual mandate

The Congressional Budget Office (CBO) said passing an Affordable Care Act (ACA) stabilization measure after getting rid of the ACA’s individual mandate would still leave 13 million fewer people insured by 2027 and cause premiums increase by an average of 10 percent over the same time period.

5 things to know about Alex Azar’s first hearing as nominee for HHS Secretary

One Republican said he wouldn't support the nomination of Alex Azar, if the former pharmaceutical executive can't support importation of pharmaceuticals from other countries. 

Letting states pick essential health benefits may ‘undermine’ ACA

Insurers, hospitals and regulators had a largely negative reaction to a major provision of the proposed Affordable Care Act (ACA) benefit parameters for 2019 that would allow states to define their own “essential health benefits” which ACA-compliant insurance plans have to cover, saying it may return the nongroup market to its pre-ACA state.

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