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 [...]
Loss of Insurance Options Hitting Hospital Bottom Lines
Hospitals are starting to feel the impact of the loss of enhanced subsidies for the purchase of Affordable Care Act health insurance plans. According to officials from a number of for-profit hospital companies, they have been surprised at how few [...]
Federal Health Policy Update for August 6
Don’t Miss: CMS issues final FY 2027 Medicare inpatient payment regulation HRSA introduces revised 340B rebate model CMS gives states new tool to help identify non-citizen Medicaid applicants The following is the latest health policy news from the federal government [...]
More Medicaid DSH Money Coming for Some Hospitals?
Some hospitals may be in line for larger Medicaid disproportionate share hospital payments as a result of a federal court decision that calls for changes in how those Medicaid DSH payments are calculated. Last week, a U.S. District court in [...]
Rural Areas Account for Net Loss of U.S. Hospitals
Rural hospitals are closing at a significant rate while the number of urban hospitals in the U.S. is mostly holding steady, according to a new analysis. The Health Care Affordability Lab at Yale found that between 2001 and 2023, 114 [...]
