Entries by NASNH Administrator

Bill Would Clarify Medicare’s “Two Midnight Rule”

A new bill introduced in the Senate last week would attempt to clarify Medicare’s so-called two-midnight rule for classifying hospital stays as inpatient stays or observation status and resolve the controversy surrounding the much-discussed rule. The Two-Midnight Rule Coordination and Improvement Act proposes establishing new criteria to govern how Medicare pays hospitals for short stays. […]

Increase Use of Value-Based Purchasing, HHS Told

A study performed for the U.S. Department of Health and Human Services calls for greater use of value-based purchasing in federal health care reimbursement policy. The study, performed by the RAND Corporation, recommends developing a national value-based purchasing strategy; developing a more deliberate approach to evaluating the effectiveness of value-based purchasing efforts; and developing performance […]

President Presents Proposed FY 2015 Budget

Yesterday the Obama administration unveiled its proposed FY 2015 federal budget. The spending plan addresses a number of key matters for private safety-net hospitals, including proposed cuts in Medicare bad debt reimbursement, graduate medical education payments, market basket updates for selected providers, and more. It also proposes increased spending to train more health care providers […]

CMS Offers Additional Guidance on “Two-Midnight Rule”

The Centers for Medicare & Medicaid Services (CMS) has issued additional information about its plans for implementing the so-called Medicare two-midnight rule. The rule, which officially took effect last August, has been the subject of controversy, questions, and clarifications ever since, with CMS issuing addiitonal guidance last September and again this last month. Among other […]

States Face Challenges in Outside-the-Box Medicaid Expansion

For most states expanding their Medicaid program in response to the opportunity afforded by the Affordable Care Act, expansion has been fairly straightforward:  they simply let more people into their existing Medicaid programs. But several states – Arkansas, Iowa, and Michigan – have tried something different:  pursuing fundamental changes in their Medicaid programs. Among the […]

Enthusiasm Waning for Permanent Medicare Doc Fix

While most health care interests and members of Congress want to see a permanent end to the annual Medicare “doc fix” problem, it appears increasingly likely that the next “fix” will be yet another short-term patch. The obstacle?  How to pay for a permanent solution. With the price tag for a permanent solution of around […]

New Approaches to Serving Dual Eligibles Set to Launch

Provisions in the Affordable Care Act that encourage states to take new approaches to serving their dually eligible residents – low-income seniors eligible for both Medicare and Medicaid – will soon translate into new state programs. Massachusetts has already launched such an initiative, a new California program will begin in May, and 17 additional states […]

Some Hospitals Stand to Lose Medicaid Expansion, DSH Money

When the Supreme Court made Medicaid expansion optional rather than mandatory for states, its decision affected the delicate balance of one aspect of the Affordable Care Act. Hospitals that serve large numbers of low-income and uninsured patients receive special supplemental payments from Medicare and Medicaid to help subsidize the care they provide to these patients:  […]

CMS Seeks to Shape Provider Networks

Insurers offering qualified health plans in the federally facilitated marketplace will soon be required to meet federal standards for the adequacy and breadth of their provider networks. According to a letter issued by the Centers for Medicare & Medicaid Services (CMS) to insurers, the agency will seek to require qualified health plans to include in […]

Observation Status, the “Two-Midnight Rule,” and Continuing Controversy

Amid continuing complaints from hospitals, the Centers for Medicare & Medicaid Services (CMS) has delayed implementation of its so-called Medicare two-midnight rule for another six months.  Implementation of the rule, originally scheduled for October 1, 2013 and delayed for six months, is now slated for October 1, 2014. With hospitals calling for greater guidance on […]