CMS proposed rule addresses certain marketplace standards   03/17/2014
The Centers for Medicare & Medicaid Services Friday issued a proposed rule addressing various health insurance exchange and insurance market standards for 2015 and beyond under the Affordable Care Act. The rule proposes standards related to product discontinuation and renewal; quality reporting; non-discrimination standards; minimum certification standards and responsibilities of Qualified Health Plan issuers; the Small Business Health Options Program (SHOP); consumer assistance programs; and enforcement remedies in federally-facilitated exchanges. Among other provisions, the rule would require navigators and non-navigator assistance personnel to obtain authorization before accessing a consumer’s personally identifiable information; require application counselors to be recertified at least annually; subject navigators and application counselors to civil money penalties for noncompliance with federal requirements; modify the timeframe for insurers to include ICD-10 conversion costs in their medical loss ratio calculation; increase the administrative cost ceiling and profit floor for QHPs by 2% each; and provide that excess reinsurance contributions by all plans be given to the U.S. Treasury. The rule also specifies certain types of state laws applicable to navigators, certified application counselors and non-navigator assistance personnel that the Department of Health and Human Services considers to conflict with or prevent certain ACA provisions. CMS will accept comments on the proposed rule for 30 days after publication in the Federal Register.
Ad campaign urges Congress to protect patients' hospital care   03/17/2014
The Coalition to Protect America’s Health Care today launched a new 30-second TV ad voicing public reaction to the idea of additional cuts to hospital services. The ad features people sharing their opinion about how cuts to Medicare and Medicaid payments for hospital services would affect patients. The ad is part of a major new advertising campaign launched earlier this month that includes print ads at two Metro stations in Washington, D.C. The new TV ad amplifies the strong online and print presence created by the Coalition in the past year. The message: urge Congress to protect patient care and reject further cuts for hospital services by visiting the Coalition’s website or by calling 1-866-887-2273 (CARE). To view the ad and see where it will run, visit The Coalition to Protect America’s Health Care is a broad-based group of hospitals, businesses and national, state and local hospital associations dedicated to educating the public about issues affecting hospitals’ financial situation and what this means for patients and their families.
MedPAC issues March report to Congress   03/17/2014
The Medicare Payment Advisory Commission Friday released its March report to Congress, which details fee-for-service payment recommendations for 2015 approved by the commission in January. The recommendations call for a 3.25% increase in hospital inpatient and outpatient prospective payment system payments. Concurrently, they would reduce or eliminate payment differences between hospital outpatient departments and physician offices for selected procedures and pay long-term care hospitals the same rates as general acute-care hospitals for cases involving patients who are not deemed “chronically critically ill,” defined as an intensive care unit stay of at least eight days. Savings realized by cutting LTCH payments would be redistributed to create a new outlier pool for CCI cases treated in inpatient PPS hospitals. The LTCH policy would be phased in over three years. The commission also recommends that Congress freeze payments for LTCHs, inpatient rehabilitation facilities, ambulatory surgical centers, home health, hospice and dialysis providers under Medicare prospective payment systems for 2015. In addition, the commission recommends creating a readmissions reduction policy that would apply a penalty to HH payments for HH readmissions to hospitals that exceed a risk-adjusted target, and finalizes a recommendation to create a common post-acute assessment instrument for HH, skilled nursing facilities, IRFs and LTCHs in 2016. The commission also extends through 2015 its prior recommendation to freeze payments for SNFs and rebase the SNF PPS.
Altarum: Hospital jobs flat in 2013   03/17/2014
Hospitals added no new jobs in 2013, according to the latest economic indicators from Altarum Institute's Center for Sustainable Health Spending. The overall health care sector added 204,000 jobs for the year, down from an annual average of 250,000 between 2010 and 2012, the center reports. In February, hospitals lost 1,200 jobs, while ambulatory care added 8,400. Hospital price growth fell to 1.1% in January, its lowest reading since September 1998, the center said.
Hospital prices rise 0.4% in February   03/17/2014
Overall hospital prices increased 0.4% in February, and were 1.3% higher than a year ago, the Bureau of Labor Statistics reported Friday. Prices for the subgroup of general medical and surgical hospitals increased 0.3%, and were 1.1% higher than in February 2013, according to the BLS' Producer Price Indices, which measure average changes in selling prices received by domestic producers for their output. For hospitals, this translates into actual or expected reimbursement for a sample of treatments or services. The PPI for hospitals measure changes in actual or expected reimbursement received for services across the full range of payer types. This includes the negotiated contract rate from the payer plus any portion expected to be paid by the patient.