Healthcare Policy News

How to introduce quality measures that are useful for providers

April 19, 2024 - In the push toward value-based care and incentivized quality measures, providers have been left with a long, complicated to-do list. But the industry can do better, according to Brad Ryan, MD, chief growth officer at NCQA. In 2017, CMS introduced an entire initiative to reduce the burden of quality measurement on providers. The Meaningful...

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ACOs Flock to CMS Shared Savings Program, NSA Averts Surprise Billing

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The CMS Medicare Shared Savings Program (MSSP) saw an uptick in accountable care organization (ACO) involvement. The agency announced that 480 ACOs are participating in the MSSP and 245...

Providers Laud Prior Authorization Rule, EHRs Can Lower Provider Burnout

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Providers were encouraged by the new CMS rule on prior authorizations, which holds payers to a higher standard on prior authorization denials, transparency, and timing. The new rule, which CMS...

CMS Starts Maternal Health Program, 2022 National Spending Normalizes

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CMS announced an initiative to improve maternal health outcomes for Medicaid and CHIP beneficiaries. The new initiative, called the Transforming Maternal Health model, will last ten...

CMS Cuts Medicare Pay, AHA Sues HHS on Tracking Technology Policy

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In its calendar year (CY) 2024 Medicare Physician Fee Schedule (PFS), CMS announced it will slash Medicare payments by 1.25 percent. Primary care and direct patient care providers received an...

Federal Health Agencies Invest Big in Public Health Initiatives

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In this week's roundup, federal health agencies unveil plans to invest in critical public health initiatives o bolster public health infrastructure, improve disease response mechanisms, and advance...

Healthcare Leaders Reveal Concerns About Generative AI, Ransomware

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Today’s top stories focus on leading cybersecurity concerns, new nursing home standards, and troubling findings about behavioral health access. Generative AI and Ransomware Top Cybersecurity...

Healthcare Costs Hurting Individuals and the US Healthcare System

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Today’s roundup focuses on pricing disparities of drugs and hospital services, the burden of medical debt on middle-class Americans, and the financial implications of data breaches caused by...

CMS Reinstates Original IDR Fee, HHS Launches Heat-Related Illness Tracker

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In healthcare policy news this week, CMS was sued by the Texas Medical Association after hiking independent dispute resolution fees by 600 percent in December. Meanwhile, HHS is launching a...

House Passes $1.9B Budget for VA EHRM, Uninsured Rate Drops During COVID

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In healthcare policy news this week, an appropriations act aims to overhaul the VA’s Oracle Cerner EHR implementation. Meanwhile, HHS data showed that 6.3 million people gained healthcare...

CMS Pauses Medicaid Redeterminations, $44M Telehealth Fraud Scheme

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In healthcare policy news this week, CMS is pausing several state coverage redeterminations in light of procedural challenges that have resulted in millions losing their health insurance. Meanwhile, a...

OIG Finds $784M in Improper Payments, Officials Push HHS to Expand HIPAA

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In healthcare policy news this week, OIG agents report that HRSA’s uninsured program was plagued with claims that never should have been reimbursed. Meanwhile, representatives are pleading with...

CMS to Cut Medicare Payment Rates, FDA Approves OTC Birth Control

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In healthcare policy news this week, the Opill, a progestin-only daily birth control pill, will be available without a prescription in early 2024. Meanwhile, CMS plans to cut payment rates for some...

CMS Doles out $9B After Supreme Court Ruling, FDA Approves Leqembi

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In healthcare policy news this week, the American Hospital Association (AHA) rejoiced with news that CMS would pay $9 billion to rectify previous 340B payment cuts. Meanwhile, Alzheimer’s...

NY Schools to Offer Telemental Health, USPSTF Updates Anxiety Screenings

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In healthcare policy news this week, school leaders from the Rochester City School District are instituting a telemental healthcare program for students. Meanwhile, the nation’s preeminent...

AHA and FTC Tussle Over Antitrust, Senators Reintroduce Virtual Care Act

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In healthcare policy news this week, an AHA friend-of-the-court brief derided the Federal Trade Commission as biased. Meanwhile, a large group of United States senators is working to push the CONNECT...

CMS Pitches New Value-Based Care Model, Medicare Spending Rises Fast

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In policy news this week, CMS will test a new value-based care model in eight states. The model offers participants additional revenue to improve their primary care services. Meanwhile, research from...

How Analytics Tools, Third-Party Tracking Tech Pose Threats to Patient Privacy

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The transfer of sensitive data to non-HIPAA-covered entities may result in compliance complexities, data breaches, lawsuits, and threats to patient privacy. Following multiple high-profile healthcare...

Officials Probe Google for Data Practices, CMS Withdraws Vaccine Mandate

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In policy news this week, elected officials are pushing Google to get stricter with its health data-sharing policy. Meanwhile, CMS rescinded its health worker vaccine mandate. Senators Ask Google to...

VA May Cut Staff to Pay for EHR, FTC Sues to Block Amgen Horizon Mega Deal

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In policy news this week, Department of Veterans Affairs (VA) officials were denounced by a sitting congresswoman for implying that facilities would have to cut staff in order to pay for budget...

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