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That state has defined autism behavioral therapy as a type of medical benefit not subject to the mental health parity law, a move that allows insurers more latitude to limit the benefits they offer.
Hospitals and drug makers are waging a pitched battle over the program — known as 340B — that requires drug manufacturers to give steep discounts to hospitals that treat a large percentage of poor patients.
Critics argue that some facilities using the program should not be eligible and that the money they receive from the sale of the discounted drugs is not always being plowed back into patient care.
The 1 percent cut in payments is the latest effort by the federal government to improve hospital care.
Out of all 761 hospitals that are in line to be penalized for high rates of infections and complications this fall, 175 of them are most likely to be penalized because their preliminary scores are nine or above on a scale of 1 to 10.
Before assessing penalties, Medicare assesses rates of infection among patients with catheters in major veins and in the bladder and eight other patient injuries, such as blood clots, bed sores and accidental falls.
Officials did not properly prioritize or track investigations, leading to delays and incomplete probes, according to a state audit.
KHN’s consumer columnist says the health law initially allowed some plans to do that, but that provision is no longer valid.
The most satisfied were those who received subsidies; the least satisfied had their previous plans canceled.
More states are creating all-payer claims databases. Find out how they work.
The aerospace giant is teaming with accountable care organizations to save themselves money by taking the “middle men” — insurers — out of their health care equation.
Many are encouraging the use of less-costly regimens and paying the same for drugs, whether they’re given in hospital outpatient settings or doctors’ offices.
