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Week in Washington 07/11/24
CMS Regulation Releases CMS released a series of proposed payment regulations this week. Congress is considering increasing Medicare payment rates however no legislation is expected to pass until after the election. FTC to Sue PBMs The Federal Trade Commission is expected to sue the three biggest pharmacy benefit managers (CVS Caremark, Express Scripts, Optimum Rx) ... Read more
Events & More
Unlocking Solutions in Medicaid, Medicare, and Marketplace
With more demand for Behavioral Health than ever before, we must identify ways to make integrated behavioral health sustainable and effective, and to connect with the people needing services. That’s why our HMA Fall Conference agenda covers the topic from all angles, starting at the pre-conference, to the main stage, and in the breakout sessions.
Newsworthy Findings
Judge pauses CMS rule capping compensation for Medicare Advantage brokers
Texas Judge Reed O’Connor’s decision suggests he could overturn at least part of the rule, which is meant to curb predatory plan marketing to seniors.
Medicare proposes 2.6% bump to hospital outpatient pay next year
The sweeping payment rule also solidifies continuous eligibility requirements for children in Medicaid and CHIP and holds hospitals to higher obstetric care delivery standards.
The Supreme Court Just Limited Federal Power. Health Care Is Feeling the Shockwaves.
A landmark Supreme Court decision that reins in federal agencies’ authority is expected to hold dramatic consequences for the nation’s health care system, calling into question government rules on anything from consumer protections for patients to drug safety to nursing home care.
CMS revised Medicare Advantage star ratings. Here’s which payers benefited.
More than 60 Medicare Advantage health plans offered by 40 insurers received a higher star rating for 2024 after the CMS was forced to recalculate the scores, after losing two court cases about how it previously calculated the ratings, which underpin massive bonuses for insurers in MA.
Pandemic policies have fewer adults skipping medical care due to cost
Medicaid enrollment increased dramatically during the public health emergency when Medicaid disenrollments were suspended. Enhanced subsidies were extended through 2025 under the Inflation Reduction Act and are associated with increased marketplace enrollment.
Bonus Article
Michael Bloomberg Donates $1 Billion to Provide Free Tuition for Future Doctors at Johns Hopkins
Just for Fun
Math Riddle:
Why is it sad that parallel lines have so much in common?
Prior Week
Prior Week:
Q: How are a dollar and the moon similar?
A: They both have 4 quarters
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