Policy and Legislation

While a referral arrangement reversal has upset the applecart for some, most providers are taking it in stride.

Late last week, the Health Resources and Services Administration released the results of its FY 2012 audits of covered entity compliance with 340B drug discount program rules. The agency discovered several "recurring critical areas of non-compliance" for healthcare facilities.

Twenty-four states, including almost the whole South, took the stubborn path and have so far refused to expand Medicaid. That's a big reason rural hospitals are continuing to struggle.

A new Medicare prospective payment system for federally qualified health centers offers improved reimbursement rates.

The latest data from the Bureau of Economic Analysis estimate that spending for healthcare services jumped by about $50 billion in the first quarter of 2014 compared to fourth quarter of 2013. But don't listen to those who say we are on track for a 10 percent rise in health spending over the full year.

Although they're not expanding Medicaid under the Affordable Care Act, Texas, Florida and other states are expanding managed care, bringing insurers opportunities as well as challenges, including competition from provider-based health plans.

The proposal for next year's Medicare inpatient payments to hospitals continues the pressure on them, and doubles down on a controversial policy.

Hospitals may have less control over readmissions than clinicians, administrators or federal regulators would like to believe, new research suggests, meaning that the readmissions penalties imposed by the Centers for Medicare & Medicaid Services may be inappropriate.

As lawmakers try to understand the ultimate causes of the recent slowdown in healthcare spending growth, their determinations will eventually translate into policies that will impact healthcare businesses of all types.

Providers of Medicare Advantage and Part D plans: look out. Dozens of plans may soon be terminated.