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Policy

 

The deal to fund the Affordable Care Act (ACA)’s halted cost-sharing reduction subsidies while expanding the state waiver process has the support of several major healthcare groups along with 10 governors and 24 senators. President Donald Trump, however, hasn’t been clear on whether he’ll support the bill as-is.

President Donald Trump is considering nominating Alex Azar, a former executive for pharmaceutical giant Eli Lilly, as the next secretary of HHS, which could place the agency in the hands of man who has been skeptical of value-based care and opposed drug price controls.

Sens. Lamar Alexander, R-Tennessee, and Patty Murray, D-Washington, have told reporters they’ve reached an agreement to fund the Affordable Care Act (ACA)’s cost-sharing reduction subsidies to insurers which had been halted by President Donald Trump.

Groups representing physicians, hospitals and patients came out largely in opposition to President Donald Trump’s executive order to encourage the use of insurance plans which don’t comply with Affordable Care Act (ACA) regulations on benefits and covering people with pre-existing conditions.

Cost-sharing reduction subsidies, or CSRs, paid to insurers in exchange for keeping out-of-pocket costs low for lower-income Affordable Care Act (ACA) exchange enrollees will end, HHS announced Thursday night, with the agency saying it couldn’t legally continue making the payments.

 

Recent Headlines

HHS provides nearly $200 million to hospitals, states to deal with Ebola virus

Hospitals and states will receive nearly $200 million in funds from the Department of Health and Human Services to prepare for and respond to the Ebola epidemic.

CMS proposes decreasing payments to Medicare Advantage plans

CMS is proposing to decrease payments per beneficiary to Medicare Advantage organizations in 2016 by an average of 0.95 percent.

Special enrollment period for health insurance marketplaces

The Centers for Medicare & Medicaid Services announced on Friday a second enrollment period for people to purchase insurance coverage through the health insurance marketplaces.

President Obama: Affordable Care Act is working better than anticipated

More than 11 million people have purchased coverage on the health insurance exchanges for 2015, according to preliminary figures released in a video the White House posted on Facebook on Tuesday.

Supreme Court case could lead to a large decrease in hospital revenue

If the Supreme Court rules in favor of the plaintiff in the upcoming King v. Burwell case, hospital spending would decrease by at least an estimated $6.3 billion, according to an Urban Institute report.

Congress urges HHS to update HIPAA mHealth guidance

The Department of Health and Human Services is long overdue to update its HIPAA guidance to better regulate the rapidly evolving mobile health industry market, according to two House representatives.

CMS schedules three testing weeks for ICD-10

The Centers for Medicare and Medicaid Services has announced that it will hold three separate testing weeks to allow trading partners (including physician practices, hospitals and other healthcare providers) the opportunity to try out submitting claims using International Classification of Diseases, 10th Revision (ICD-10) codes.

AHA seeks changes in House bill to reduce fraud, waste and abuse in Medicare

The American Hospital Association (AHA) this week submitted comments to the U.S. House Committee on Ways and Means, Subcommittee on Health about the Protecting the Integrity of Medicare Act (PIMA), a bill that seeks to save the government money by making it harder to successfully defraud the system.

Pharma pushes back against CMS implication that industry is behind problems with Open Payments system

As issues continue with the Centers for Medicare and Medicaid Services (CMS) system for collecting data on industry payments to physicians and making a physician-verified version of that data available to the public by September 30, the Pharmaceutical Research and Manufacturers of America (PhRMA) industry group says don’t blame industry for data problems.

Beneficiaries now also suing about long wait for Medicare appeals hearings

Earlier this year, the American Hospital Association (AHA) and three hospital and healthcare systems sued the U.S. Department of Health and Human Services (HHS) over the long backlog in Medicare claim denial appeals. Now patients are joining in with a nationwide class action suit.

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