Policy and Legislation
As the dust settles from the Supreme Court's ruling on the constitutionality of the Affordable Care Act (ACA), the results of the presidential election and, more recently, the sequester cuts, acute care providers are now turning attention to the looming reimbursement cuts.
With the Affordable Care Act entering the home stretch of implementation, U.S. Senators are still trying to understand the costs and benefits of insurance market reforms, while diagnosing problems in the greater healthcare system.
A new report by Trust for America's Health says prevention improves health and productivity and saves billions, but is prevention really cost effective?
With no comprehensive program designed to provide long-term care insurance, a panel of experts who convened in March agreed that comprehensive reform has about a five-year window for implementation in order to sufficiently meet the needs of baby boomers.
President Barack Obama's fiscal 2014 budget includes a variety of what he says are "manageable" changes for Medicare's 54 million beneficiaries as well as for the hospitals, nursing homes and other healthcare providers that serve them.
In January, the Affordable Care Act (ACA)’s individual mandate will enter the next phase of its roll out. Millions of uninsured Americans will face penalties if they do not enroll in a health plan. Uninsured problem solved, right?
Among the least popular decisions handed down by the Centers for Medicare & Medicaid Services in recent years, it’s hard to top the rule requiring hospitals to rein in readmission rates or suffer the financial consequences. As most CFOs are painfully aware, those consequences include substantial reductions in reimbursements.
By now, it is no surprise which states have said they won’t expand Medicaid as outlined under the Affordable Care Act. And while there are still a handful of states on the fence, it’s a given that states like Texas, Louisiana, Mississippi and Georgia, among others, were not going to budge.
Hospitals in states that don’t expand their Medicaid program as outlined under the Affordable Care Act are facing significant revenue reductions due to regulations that will reduce some Medicare and Medicaid payments in 2014, measures that were written into the law to help pay for the expansion of the insurance program for the poor.
The American Medical Association has challenged a Georgia court’s blocking of a prompt payment law and in the process has raised questions about some of the pillars of federal preemption under the Employee Retirement Income Security Act (ERISA) as it relates to third-party administrators and self-funded insurance plans.