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340B Guidance: When a Patient Is Not a Patient
Infographic shows how proposed 340B program guidance would harm patient access.

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A leaked House GOP plan to repeal & replace the ACA raises concerns for essential hospitals. A Senate committee considered nominee Seema Verma to lead CMS. view more »

CMS has pushed back by seven weeks the deadline for qualified health plans to apply to participate in the ACA health insurance marketplaces in 2018. view more »

The proposed rule aims to provide flexibility by targeting network adequacy reviews & inclusion of essential community providers in qualified health plans. view more »

The delay is in accordance with a “regulatory freeze” set forth in a recent White House memorandum. view more »

On February 16, a policy brief by House Republicans on how they would repeal and replace the Affordable Care Act (ACA) was leaked in Washington. Learn more about what was included. view more »

CMS has extended the deadline for submitting certain hospital quality data after receiving reports of system issues and inaccessibility with QualityNet. view more »

Former Rep. Tom Price was confirmed as secretary of HHS; the Senate Committee on Finance will consider the nomination of Seema Verma as CMS administrator. view more »

Using 3-D imaging to treat atrial fibrillation showed a 100 percent success rate, a zero percent complication rate, and led to quicker patient recovery. view more »

CMS projects that Medicare Advantage organization payment rates will increase by 0.25 percent in 2018. view more »

A House subcommittee marked up two bills focused on income eligibility for Medicaid. The association weighed in on a hearing about the individual mandate. view more »

The Feb. 7 letter offers recommendations on proposed executive orders, regulations, and legislation that could affect essential hospitals, patients. view more »

Eligible hospitals and professionals now have until March 13 to attest to the Medicare Electronic Health Record (EHR) Incentive Program. view more »

America’s Essential Hospitals and 57 other groups say restricting admission of certain foreign nationals and refugees will disrupt care, health education, and research. view more »

No agreements have been reached about a repeal/replacement plan for the ACA and it appears Republicans in both chambers are far from making final decisions. view more »

The new guidance outlines how and when hospitals must deliver the notice, retention requirements, and how the notices intersect with state laws. view more »

The second confirmation hearing was held for Rep. Price as HHS secretary and a House subcommittee held a hearing on the individual mandate's effectiveness. view more »

The 60-minute webinar on new episode payment models for cardiac care and surgical treatment for hip and femur fractures will begin at noon ET on Feb. 9. view more »

A memo instructs all executive departments and agencies to temporarily halt pending regulations until incoming department or agency heads can review them. view more »

Hospitals now have until March 13 — instead of Feb. 28 — to submit electronic clinical quality measure data from 2016 to CMS. view more »

Along with renewing ACOs, the 99 new organizations bring the total number of ACOs nationally to 480 in 2017. view more »

With House and Senate passage of budget resolutions, efforts to repeal the Affordable Care Act now move to committees and toward a Jan. 27 deadline for repeal legislation. view more »

Jan. 18 rule finalizes additional restrictions proposed in November 2016 on the ability of states to increase or add new pass-through payments under Medicaid managed care plan contracts. view more »

When a fire broke out at the University of Texas Medical Branch's John Sealy Hospital, 110 patients, their visitors, and the staff had to evacuate. view more »

Late on Jan. 11, the Senate passed S. Con. Res. 3, the FY 2017 budget resolution, an important first step among several needed to repeal much of the ACA. view more »

Debate and amendment votes in the Senate are expected though the weekend. The Senate measure then will go to the House for consideration. view more »

The new Center for Medicare and Medicaid Innovation model aims to boost participation from small rural hospitals and other smaller health care practices. view more »

The regulation makes "penny pricing" final and sets fines of up to $5,000 per instance of a manufacturer overcharging providers for covered medications in the 340B Drug Pricing Program. view more »

OIG found that the federal portion of spending on catastrophic coverage reached $33.2 billion in 2015, compared with $10.8 billion in 2010. view more »

Hawaii is the first state to receive approval for a Section 1332 waiver, and will be allowed to close its Small Business Health Options Program for five years. view more »

CMS also expanded the Comprehensive Care for Joint Replacement (CJR) model to include surgical hip/femur fracture treatment. view more »

Essential hospitals can expect the new Congress' Republican leaders to follow through quickly with their pledge to repeal the Affordable Care Act. view more »

The changes, which reflect stakeholder feedback and the large volume of changes to ICD-10 in FY 2017, will be available on the National Library of Medicine’s Value Set Authority Center this month. view more »

New guidance describes how off-campus hospital provider-based departments can maintain their grandfathered status when relocating due to extraordinary circumstances. view more »

These new EPMs and the updated CJR model will give clinicians more opportunities to earn incentive payments through advanced alternative payment models. view more »

Of particular interest to essential hospitals, CMS revised the Worksheet S-10, which hospitals use to report uncompensated care data. view more »

A CMS spokesperson said the project was pulled after the agency reviewed public comments — there were more than 1,300 comments submitted, mostly negative. view more »

CMS finalized a proposal to continue the current methodology, which qualified health plans use to satisfy the minimum essential community provider standard. view more »

MACPAC's recommendation is part of a larger package of suggestions meant to improve coverage for children in low- and moderate-income families. view more »

CMS will partner with up to six states on the new Medicare-Medicaid ACO Model, which was designed by the CMS Innovation Center. view more »

The BBA’s “site neutral” policy creates serious, unintended consequences for vulnerable people, and CMS rules do not provide enough flexibility. view more »

The association is urging policymakers to pair any repeal of the Affordable Care Act with simultaneous passage of a comprehensive replacement. view more »

The new 227,420-square-foot clinic will build on the former CEO's vision of ensuring health care for the most vulnerable among us. view more »

President Obama signs the 21st Century Cures Act, which includes the historic risk adjustment provision and also provides partial relief to hospitals from cuts to off-campus outpatient department payments. view more »

Lawmakers approve funding for the federal government through April 28, 2017, and pass legislation that includes two key advocacy wins for essential hospitals: socioeconomic risk adjustment and partial relief from outpatient department payment cuts. view more »

Essential hospitals should be equipped with key information to understand this procedural tool that likely will be used early next year to begin the process of dismantling the Affordable Care Act (ACA). view more »

Under the rule, OIG provides safe harbor protections for hospital agreements that provide no-cost or discounted local transportation to established patients view more »

America's Essential Hospitals takes part in the Provider and Hospital Week of Action to promote open enrollment for insurance marketplaces under the ACA. view more »

Fifteen patients affected by the "Chimney Tops 2" fire in Tenn. were taken to the ED at University of Tennessee Medical Center, the area's only level I trauma center. view more »

The two new Beneficiary Engagement and Incentives models test different shared decision-making approaches designed to increase patient engagement. view more »

All hospitals and critical access hospitals will be required to provide the MOON to applicable patients beginning March 8, 2017. view more »

Hospitals can request an exemption from the electronic clinical quality measure reporting requirement in the Hospital Inpatient Quality Reporting Program. view more »

The legislation, expected to quickly receive the president's signature, includes two key advocacy goals for the association: risk adjustment of the Hospital Readmissions Reduction Program and partial relief from hospital outpatient department payment cuts. view more »

The CMS FAQ answers questions about new regulatory requirements to ensure health care facilities are ready for disasters and public health emergencies. view more »

Congress plans to vote on a continuing resolution to keep the government running past Dec. 9. The Senate is expected to pass 21st Century Cures legislation. view more »

The bill is a step toward expanding Project ECHO, an innovative “hub and spoke” education model created at association member University of New Mexico Health Sciences Center. view more »

America's Essential Hospitals expressed continued concerns about qualified health plan network adequacy in federally facilitated marketplaces. view more »

Jennifer Pisano, associate medical director of The University of Chicago Medicine's Antimicrobial Stewardship Program, discusses proper use of antibiotics. view more »

Rep. Tom Price has been nominated to head HHS and Seema Verma, who graduated from the association's Fellows Program in 2001, has been nominated to lead CMS. view more »

cms, hhs

Congress is poised to pass legislation that would include socioeconomic risk adjustment for the Hospital Readmissions Reduction Program and some relief from payment cuts for new hospital outpatient departments. view more »

Lawmakers are closing in on negotiations for 21st Century Cures legislation and also working to complete a short-term continuing resolution to fund the federal government through March 2017. view more »

The proposed rule would codify additional restrictions, first outlined in July 2016, on the ability of states to increase or add new pass-through payments under plan contracts. view more »

The notice contains state-specific FMAPs, used to determine the amount of federal matching funds for state Medicaid programs; and enhanced FMAPs, used to calculate federal funding for the Children’s Health Insurance Program. view more »

America's Essential Hospitals has important and promising information to share with members about our fight to stop damaging regulatory changes to the 340B Drug Pricing Program. view more »

The agency released software that will help developers build applications for clinicians and their practices and make it easier for organizations to retrieve and maintain QPP measures using the Explore Measures section of the QPP website. view more »

Starting in 2017, nurse practitioners and physician assistants can train to prescribe buprenorphine for the treatment of opioid use disorder. view more »

The impending full control of government by Republicans is expected to kick start discussions about repealing the Affordable Care Act and passing entitlement reform. view more »

The letter provides operational and technical guidance to issuers of qualified health plans through the federal health insurance marketplace for 2018. view more »

The FAQ provides clarification on managed care contracts, rating periods, and external quality reviews, among other things. view more »

The campaign of advertisements and media outreach calls on Congress to pass legislation to risk adjust the Hospital Readmissions Reduction Program. view more »

The proposed revisions would update requirements on patient safety and quality improvement, physician well-being, team-based care & resident work hours. view more »

These long-term HCBS services and supports are critical to ensure people can remain in their homes and communities as they receive treatment. view more »

The letter was signed by America's Essential Hospital and 20 other national organizations. view more »

Under the rule, CMS would increase the OPPS payment rate by 1.65 percent and provide flexibility in the meaningful use of EHRs, among other things. view more »

Of particular interest to members of America’s Essential Hospitals are changes to the Medicare Shared Savings Program and provisions related to telehealth. view more »

CMS provides more flexibility than previously proposed, ensuring non-grandfathered, off-campus hospital outpatient departments will be reimbursed in 2017. view more »

In the rule, CMS revised its earlier position not to direct any physician fee schedule payments to non-grandfathered, off-campus hospital clinics in 2017 and, instead, established a 50 percent interim rate. view more »

The open enrollment period runs from Nov. 1 through Jan. 31, 2017. Consumers must enroll by Dec. 15 for coverage that begins Jan. 1, 2017. view more »

The guide gives states information they need to develop actuarial rate certifications, such as benefit cost projections, pass-through payments, and risk mitigation strategies. view more »

The notice contains state-specific, final FY 2014 disproportionate share hospital allotments, without reductions that would have been imposed under the ACA. view more »

With the opportunities, clinicians potentially could earn a 5 percent incentive payment for a growing list of alternative payment models in 2017 and 2018. view more »

Association president and CEO argues that hospitals serving disadvantaged communities are penalized by federal quality initiatives that do not account for socioeconomic obstacles. view more »

Aids provided by the Centers for Medicare & Medicaid Services include fact sheets and overview documents, lists of alternative payment models, webinars and other educational tools, and support contacts. view more »

An Oct. 14 final rule establishes a new approach to physician payment required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA): the Quality Payment Program. view more »

Under the rule, the Office of the National Coordinator for Health Information Technology now can conduct direct surveillance of certified health information technology. view more »

The rule establishes a "transition year," as well as flexibility for providers to choose their participation pace. view more »

The White House held a summit on increasing health coverage among young adults ahead of the next open enrollment period under the ACA, which begins Nov. 1. view more »

The National Health Information Sharing and Analysis Center received the funding to educate health care sector stakeholders, partners on cybersecurity. view more »

If left unchecked, antibiotic-resistant infections will kill 10 million people a year and cost the worldwide economy $100 trillion by 2050. view more »

CMS says it miscalculated some hospitals' uncompensated care share and provided the incorrect wage index reclassification status of four hospitals. view more »

Hospitals and eligible professionals now can register to submit National Health Care Survey data in 2017. view more »

Congress passed a bill to fund the government through Dec. 9. Meanwhile, 179 House members sent a letter urging CMS to stop mandatory payment and service delivery demonstrations. view more »

Providers approved for a patient limit increase must report on caseload, patients referred to behavioral health care, and their diversion control plan. view more »

CMS will use social video platform Twitch, improve the HealthCare.gov mobile interface, and use #HealthyAdulting to encourage young adults to sign up. view more »

The Medicare Access and CHIP Reauthorization Act of 2015 requires CMS to remove Social Security numbers from beneficiaries’ Medicare cards by April 2019. view more »

For Sepsis Awareness Month, in September, we spoke to experts at two member hospitals, Parkland Health & Hospital System and UNM Health Sciences Center, about their efforts to prevent and care for sepsis. view more »

Cohen, a former hospital administrator at NYC Health + Hospitals and America's Essential Hospitals board chair in 1995, died Sept. 24 at age 80. view more »

On Sept. 27, the Senate failed to invoke cloture, which would have allowed it to move to final passage of the continuing resolution. view more »

ONC has released a web-based resource that gives providers comprehensive, easy-to-understand information about applying health information technology. view more »

Recognizing the opportunity for improvement in geriatrics care, association members NuHealth and Zuckerberg San Francisco General Hospital have made falls prevention a priority. view more »

Hospitals eligible for the essential community providers list are participants in the 340B and DSH programs, critical access hospitals, and others. view more »

In May, CMS paused initial patient status reviews to ensure reviews are performed consistently and the two-midnight policy is properly applied. view more »

At stake is funding to combat the Zika virus, among several other policy issues that have kept the measure from moving forward. view more »

The webinar will focus on the Advancing Care Coordination through Episode Payment Models proposed rule. view more »

A new policy brief by America's Essential Hospitals notes that managed care pathways might be a potential complement to waiver-based delivery system reform. view more »

Medicare reimbursement is slated to be cut by as much as 50 percent for new, off-campus hospital outpatient departments not billing for services provided before Nov. 2, 2015. view more »

The rule sets forth national requirements for Medicare and Medicaid providers and suppliers to ensure health care facilities are prepared for emergencies. view more »

The deadline for hospitals to amend their Medicare cost report Worksheet S-10 for fiscal year 2014 is Sept. 30. view more »

While details are still being finalized, a continuing resolution to fund the government through early December likely will include funding to combat Zika. view more »

Without Medicaid DSH payments, our members would have suffered a 6.21 percent loss in 2014. Congress should postpone DSH cuts until at least FY 2020. view more »

A per-capita cap would allow the federal government to limit Medicaid spending by allocating a specific amount of funding based on states' enrollees. view more »

CMS is seeking feedback on how to help states implement innovative payment, care delivery models consistent with MACRA's proposed Quality Payment Program. view more »

The Accountable Health Communities Model aims to close a gap in the health care delivery system between clinical care and community services. view more »

Comments on the proposed Notice of Benefit and Payment Parameters for 2018 are due by Oct. 6. view more »

Congress seems likely to pass a continuing resolution to fund the government beyond Sept. 30. Lawmakers also are expected to approve funding to combat Zika. view more »

The grants to support marketplace navigators come as exchanges gear up for the Nov. 1 start of open enrollment for coverage beginning in 2017. view more »

In a FAQ document, CMS states that the required JW modifier and patient documentation policy applies to separately payable Part B drugs. view more »

Hospitals must complete recertification of their compliance with all requirements of the 340B program. Failure to do so results in removal from the program. view more »

ONC is requesting feedback particularly on interoperability as it relates to social determinants of health and collection of gender identity data. view more »

CMS is concerned that some providers might steer Medicare- and Medicaid-eligible patients into individual market plans to get higher payments. view more »

Review contractors will be able to use coding specificity as the reason for an audit or a denial of a claim to the extent that they did before Oct. 1, 2015. view more »

Medicare Part D spending increased 17 percent, outpacing overall prescription drug spending increases, according to CMS data. view more »

A webinar and new election toolkit from America's Essential Hospitals can help to make sure hospitals' voices are heard this congressional election season. view more »

The rule would codify the interpretation that the calculation be based on uncompensated care costs for Medicaid beneficiaries not covered by another source. view more »

HRSA is proposing that a decision-making body within the Department of Health and Human Services be responsible for reviewing claims and resolving deputes. view more »

Pokémon Go, the augmented-reality game, has helped pediatric patients at Seattle's Harborview Medical Center recover from burn injuries. view more »

As essential hospitals leaders, we all need to stay on top of the evolving landscape for Medicaid Section 1115 waivers. Medicaid waivers offer a key opportunity to make health care delivery more effective and efficient – and to reduce our uncompensated care burden. Consider our experience in Texas. Over the life of the Texas Health view more »

The rule addresses the controversial two-midnight policy, Medicare DSH, the Hospital-Acquired Condition Reduction Program, Value-Based Purchasing, and more. view more »

Essential hospitals strive every day to close the health care equity gap and provide quality care to all, including the most vulnerable. A new book, A Spirit of Charity, highlights the important role these hospitals play in the United States health care system. In the book, Mike King, a reporter for nearly 40 years, profiles view more »

The rule includes the annual payment update to inpatient payment rates and changes to the Medicare disproportionate share hospital payment methodology. view more »

Women bring critical perspectives to hospital leadership roles, yet they are significantly underrepresented, especially in CEO positions. America’s Essential Hospitals and its members are committed to reducing this gender gap in hospital leadership. For one, essential hospitals have long worked to promote equity — both in delivery of care and in cultivating leaders who are view more »

Model will test new episode payment models for acute myocardial infarction and coronary artery bypass graft, as well as expansion of the current CJR model. view more »

CMS will issue future rulemaking to further restrict new or increased pass-through payments under Medicaid managed care plan contracts. view more »

Public hospitals have always played an important role in the United States health care system and their contributions are emphasized in a new book, A Spirit of Charity. In the book, Mike King, a reporter for nearly 40 years, profiles three members of America’s Essential Hospitals — Grady Memorial Hospital in Atlanta, Parkland Memorial Hospital view more »

The release comes after America’s Essential Hospitals and other hospital groups urged CMS to delay the ratings due to serious concerns with the methodology. view more »

Urge congress to vote for the “Establishing Beneficiary Equity in the Hospital Readmission Program Act" and support hospital star ratings transparency. view more »

Under the models, hospitals would be financially accountable beginning July 1, 2017, for meeting quality and cost measures for the entire episode of care. view more »

On July 25, two teenagers were killed and at least 16 other people were injured in the second mass shooting in Florida this summer. view more »

America’s Essential Hospitals supports H.R. 5273, the Helping Hospitals Improve Patient Care Act. Section 102 of the bill would help level the playing field for essential hospitals in Medicare's readmissions reduction program. view more »

The new guidance reinforces the importance of compliance with HIPAA to prevent and recover from cyber threats. view more »

When Congress resumes, it will race to pass legislation to keep the government running beyond Sept. 30. view more »

About America’s Essential Hospitals

America’s Essential Hospitals is the leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. Since 1981, America’s Essential Hospitals has initiated, advanced, and preserved programs and policies that help these hospitals ensure access to care. We support members with advocacy, policy development, research, and education.

America’s Essential Hospitals was formerly known as the National Association of Public Hospitals and Health Systems (NAPH). Carrying our mission since 1981 into today's health care era

Learn more about the name change »