Medicare & Medicaid
The Medicaid managed care organization was accused of submitting inaccurate billing requests to the state in its capacity as PBM.
Without action from Congress, the AHA estimates hospitals will lose at least $3 billion by the end of the year.
The tradeoff is the same cap would increase per capita spending on Medicare by 1,000, or 7.8% on average.
Plus, Medicare and Social Security are facing long-term financing shortfalls under currently scheduled benefits and financing.
Enrollment growth was strong in Medicaid and Medicare Advantage, but was partly offset by increased medical costs.
The hospital lost Medicare and Medicaid funding after a series of compliance issues, but lawmakers call the facility essential.
New CMS report requested by HHS Secretary Becerra shows savings can be passed on to Medicare beneficiaries in 2023.
The draft suggests removing Medicare's in-person visit requirement, protecting audio-only telehealth and supporting provider use.
Extended coverage is now available in 11 states and has been proposed in several more states as well as Washington, D.C.
The AHA recommends the DOJ establish a task force to examine routine denials from major health insurance companies.