Humana’s Shift to Public Insurance, CMS Proposes Changes to DSH Program
Kentucky-based Humana announced its plan to exit the employee insurance business to focus on public insurance, and CMS has proposed a rule that would change the current DSH program.
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By - This week, CMS proposed a rule that would update requirements for the Disproportionate Share Hospital (DSH) program following the Consolidated Appropriations Act of 2021. And insurance giant Humana will leave the employee insurance business in the next two years to focus on the Medicaid, Medicare, and military markets.
HHS Details Data Breaches and HIPAA in New Reports
On Wednesday, The Department of Health and Human Services Office for Civil Rights (OCR) shared a new analysis with Congress detailing the state of cybersecurity in the healthcare industry. In addition to accounts of OCR investigations and breach reports, the new research reviewed HIPAA compliance efforts and violation reviews.
“There is a continued need for regulated entities to improve compliance with the HIPAA Rules; in particular, the Security Rule standards and implementation specifications of risk analysis, risk management, information system activity review, audit controls, and access control were areas identified as needing improvement in 2021 OCR breach investigations,” the report noted. READ MORE.
Reproductive Freedom Alliance Safeguarding Access to Care
A coalition of 20 United States governors announced the formation of the Reproductive Freedom Alliance last week. The new alliance represents a safeguard against restrictive abortion laws that limit women’s access to reproductive healthcare as well as a challenge to the states that have instituted strict limits on abortion since the Roe v. Wade decision. California Governor Gavin Newsom led the group in their announcement and utilized funding from the California Wellness Foundation to launch the alliance. READ MORE.
CMS Proposes Changes to Medicaid DSH
A new proposed rule from CMS plans to update the requirements of the DSH program and clarify language to do with DSH payment and financing. The potential rule was issued in response to the Consolidated Appropriations Act of 2021, which modified Medicaid hospital-specific DSH limit calculations to include only costs and payments for patient services.
“Accordingly, the limit excludes costs and payments for services provided to Medicaid beneficiaries with other sources of coverage, including Medicare and commercial insurance),” the proposed rule states. READ MORE.
AHIP Pushes Back on 2024 Medicare Advantage
In a published statement last week, Matt Eyles, CEO of America’s Health Insurance Plans (AHIP), expounded on the organization’s argument against the proposed 2024 Advance Rate Notice for Medicare Advantage. According to AHIP, average Medicare Advantage rates would decrease by 2.27 percent in 2024, and quality bonus payments would also drop by 1.24 percent. Eyles indicated that if the proposed payments were approved, Medicare Advantage enrollees could face a higher cost burden than in the past. READ MORE.
Humana to Focus on Public Health Insurance
After a strategic review, Humana announced its decision to prioritize public insurance offerings over its employer group insurance business. The company released the statement on Monday and said it would leave the group business within two years.
“It is in line with the company’s strategy to focus our health plan offerings primarily on Government-funded programs (Medicare, Medicaid, and Military) and Specialty businesses while advancing our leadership position in integrated value-based care and expanding our CenterWell healthcare services capabilities.” READ MORE.
