Federal Health Policy Update for August 20
Don’t Miss: Latest No Surprises Act/Independent Dispute Resolution news Dept of Homeland Security issues guidance on “public charge” The following is the latest health policy news from the federal government for August 14-20. Some of the language used below is [...]
Analysis Puts Price Tag on Loss of Medicaid State Directed Payments
Thirty-seven states face the loss of significant federal Medicaid revenue depending on how the Centers for Medicare & Medicaid Services ultimately implements a provision in the 2025 reconciliation bill that called for new limits on so-called state directed payments – [...]
Non-Profit Hospitals Struggled in 2025, Moody’s Finds
The financial performance of non-profit hospitals weakened in 2025, according to Moody’s, the financial rating service company. According to Moody’s: Median operating margins fell from 1.3 percent in 2024 to 1.2 percent in 2025. Median operating income fell 13.3 percent. [...]
Mandatory Value-Based Programs Increase Hospital Costs
While policymakers continue to pursue mandatory Medicare value-based programs at least in part to help reduce taxpayers’ costs for Medicare, they may be robbing Peter to pay Paul. According to a new study, hospitals that participate in federally mandated Medicare [...]
Court Rejects No Surprises Act’s QPA Methodology
A federal appeals court has rejected how health care payers calculate their qualifying payment amount, or QPA, when addressing disputed payments under the No Surprises Act’s Independent Dispute Resolution process. The QPA is the central benchmark rate payers present to [...]
CMS Clarifies Upcoming IDR Changes
Earlier this year, the departments of Health and Human Services, Labor, and the Treasury and the Office of Personnel Management published federal Independent Dispute Resolution operations final rules to improve the functioning of the No Surprises Act’s IDR process, which [...]
Federal Health Policy Update for August 13
Don’t Miss: Federal court vacates key aspect of No Surprises Act’s IDR process President calls for changes in childhood immunizations CMS seeks billing info so it can pay APM docs their bonuses The following is the latest health policy news [...]
Disagreement Over 340B’s Future
Almost immediately after the Department of Health and Human Services announced a pilot program to test using a rebate model in the 340B Drug Pricing Program, members of Congress responded with proposed legislation that would prevent HHS from implementing that [...]
ASH Seeks House Support for Defining “Safety-Net Hospitals”
Amid a decades-long consensus that safety-net hospitals are deserving of special federal support but a long-time struggle to identify what exactly constitutes a “safety-net hospital,” the Alliance of Safety-Net Hospitals is asking members of the House of Representatives to support [...]
HRSA Tries Again With New 340B Model
Following a federal court rejection earlier this year of a previously announced pilot program to alter how the 340B Drug Pricing Program is administered, the Department of Health and Human Services’ Health Resources and Services Administration has announced that it [...]
