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Monday, Nov 6 2023

Full Issue

Medicare Requiring Hospitals To Make Pricing Information Easier To Find

New Medicare regulations aim to make hospital prices more transparent to patients by improving compliance and transparency with existing requirements and with plans to publicly assess facilities. Other Medicare news relates to home health care, outpatient reimbursements, and more.

The federal government is moving forward with a spate of proposals that will force hospitals to be better about publishing the prices they charge health insurers and patients. Federal law has required hospitals to post their prices since 2021. Compliance has been dismal, although it has improved since the government increased fines a few years ago. But the pricing information is still tough to find and confusing to interpret. (Herman, 11/3)

The Centers for Medicare and Medicaid Services鈥 threat to claw back billions of dollars in overpayments to home health agencies could trigger more industry consolidation and affect patients' access to care in their homes. CMS announced Wednesday that it would raise Medicare reimbursements to home health companies by 0.8% in 2024鈥揳 reversal from a 2.2% payment cut proposed in June. (Eastabrook, 11/3)

Hospital outpatient departments and ambulatory surgical centers will receive 3.1% increases in Medicare reimbursements under a final rule the Centers for Medicare and Medicaid Services published Thursday. These providers are set for larger pay raises next year than under the proposed rule CMS published in July, which would have hiked fees 2.8%. (Young, 11/3)

House Democrats are raising concerns with the Biden administration that Medicare Advantage plans need better oversight, citing recent STAT investigations that found insurance companies are using artificial intelligence and algorithmic software to deny care even when people still need it. (Herman, 11/3)

Also 鈥

Democrats and progressive advocacy groups are homing in on Speaker Mike Johnson鈥檚 (R-La.) past support for steep cuts to entitlements, as the new speaker embraces a deficit commission that could spotlight the issue in the runup to the 2024 election.聽President Biden called out congressional Republicans during his State of the Union address for wanting to cut the program. While budget experts say Medicare, Medicaid and Social Security are unsustainable in their current form, most Republicans acknowledge the political risks of wanting to shrink benefits 鈥 but are also opposed to tax increases to bolster the programs.聽(Weixel, 11/6)

In one of his first moves after being elected House speaker, Mike Johnson promised to form a bipartisan debt commission to tackle what he termed 鈥渢he greatest threat to our national security.鈥 The announcement sent shivers down the spines of advocates for Social Security and Medicare. That鈥檚 because when Johnson chaired the Republican Study Committee a few years ago, the conservative group called for a variety of changes to the entitlement programs that it argued would save them from insolvency. (Luhby, 11/5)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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