Hospitals in the Inpatient Quality Reporting, Prospective Payment System–Exempt Cancer Hospital Quality Reporting, and Hospital Outpatient Quality Reporting programs can view their preview reports through Aug. 14.

The tools include a checklist of required waiver elements and model templates to help states better understand their options and the waiver approval process.

The Centers for Medicare & Medicaid Services announced new payment models through the Center for Medicare and Medicaid Innovation to promote high-quality, coordinated care for patients with chronic kidney disease.

The two mandatory payment models will test prospective episode-based payments for radiation oncology therapy and end-stage renal disease treatment.

The agency proposes to rescind the requirement due to states' concerns regarding undue administrative burden.

The $100 million pilot program aims to bring telehealth services to low-income patients, veterans, and areas lacking adequate health care.

In a July 9 letter to the Department of Housing and Urban Development, America’s Essential Hospitals expressed concern that changes to federal housing assistance eligibility requirements could increase housing instability and worsen health outcomes.

Under the requirement, delayed until October, the address a hospital lists on a claim will have to exactly match agency enrollment records for the hospital to receive payment through the Outpatient Prospective Payment System.

Hospitals must complete recertification through the Office of Pharmacy Affairs Information System by Sept. 16 to remain in the 340B Drug Pricing Program.

Under five-year demonstration projects, these states are approved to receive Medicaid matching funds for treatment in facilities that qualify as institutions for mental diseases.

Louisiana is the fifth state cleared to pursue value-based purchasing agreements for supplemental rebates with manufacturers through a state plan amendment.

The administration issued a June 24 executive order addressing hospital price disclosure, quality measurement, data sharing, and the expanded use of health savings accounts.

America’s Essential Hospitals encouraged the Centers for Medicare & Medicaid Services to consider the disproportionately negative financial effect on essential hospitals of certain quality reporting requirements and administrative burden in the Promoting Interoperability Programs.

A House-passed bill to extend funding for Medicaid programs heads to the Senate; the Senate Committee on Health, Education, Labor, and Pensions introduced the Lower Health Care Costs Act.

The Medicare Payment Advisory Commission outlines issues of importance to essential hospitals, including Medicare payment strategies for Part B drugs, the Medicare Shared Savings Program,and Medicare fee-for-service spending for emergency department services.

The commission's June report to Congress includes recommendations on the use of third-party payments in calculating Medicaid disproportionate share hospital payments and on Medicaid prescription drug policy.

In a letter to the Office of Management and Budget, America’s Essential Hospitals expressed concern that changes to the consumer inflation index would negatively impact vulnerable populations’ access to Medicaid coverage.

The state plan amendment is specifically designed to allow the state to negotiate under a “subscription” model with manufacturers of prescription drugs that treat patients with hepatitis C. Washington is the fourth state cleared to pursue value-based purchasing agreements for supplemental rebates.

The decision does not impact ongoing litigation challenging Medicare Outpatient Prospective Payment System policies or Medicaid disproportionate share hospital third-party payer policy.

The agency requests feedback as part of its Patients Over Paperwork initiative to update or eliminate administratively burdensome regulations.

In July, the Centers for Medicare & Medicaid Services will require hospitals with multiple service locations to accurately enter the address of their off-campus, provider-based departments to receive payment through the Outpatient Prospective Payment System.

In June 3 letters, America's Essential Hospitals encouraged the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health Information Technology to consider the regulatory burden that new interoperability requirements would place on essential hospitals.

The rule would eliminate protection from discrimination in health care settings based on gender identity and roll back requirements to notify individuals with limited English proficiency of antidiscrimination policies and access to translation services.

An America's Essential Hospitals analysis identified more than 300 hospitals with mismatching fiscal year 2015 uncompensated care values compared with the Centers for Medicare & Medicaid Services' provided Factor 3 values.

Under current law, most individuals applying to enter the country on a visa or applying for a green card must submit an affidavit of support from a sponsor residing in the United States who meets certain criteria. The memo claims these requirements are not adequately enforced.

The agency seeks feedback on proposed criteria for selecting direct contracting entities to participate in the new population-based payment model.

The agency released a request for applications on the Emergency Triage, Treat, and Transport model for emergency ambulance services. The new model encourages treatment for Medicare beneficiaries outside the emergency department.

In a May 17 Capitol Hill briefing, leaders from NYC Health + Hospitals, East Alabama Medical Center, and Eskenazi Health shared how disproportionate share hospital funding sustains their hospitals.

The new chair is Melanie Bella, head of partnerships and policy at Cityblock Health and former founding director of the Centers for Medicare & Medicaid Services' Medicare-Medicaid Coordination Office. The Government Accountability Office also appointed a new vice chair and two new members.

The guidance lists warning signs for which hospital staff should be aware, recommendations for active shooter responses, and suggested protective measures.

Providers interested in the professional or global options under the new Primary Cares Initiative must submit a nonbinding letter of intent by Aug. 2.

A federal judge found the Department of Health and Human Services’ Medicare outpatient payment cuts in 2019 to hospitals in the 340B Drug Pricing Program were unlawful, extending a similar decision regarding 2018 cuts. The case was sent back to the agency to determine the appropriate remedy.

In a new request for information, the agency seeks ideas for innovative programs and waiver concepts states could consider in developing Section 1332 waivers. The request follows October 2018 guidance aimed at increasing state flexibility.

Revised guidance clarifies what constitutes a ligature risk and outlines a ligature risk extension process for deficient hospitals; comments are due June 17.

In a letter to state Medicaid directors, the Centers for Medicare & Medicaid Services encouraged states to partner with the agency to test innovative approaches to better serve beneficiaries who are dually eligible for Medicare and Medicaid.

The Centers for Medicare & Medicaid Services will accept applications for its second cohort of participants in the Bundled Payments for Care Improvement Advanced Model; second cohort participants will start model year three, beginning on Jan. 1, 2020.

The Primary Cares Initiative comprises five new voluntary payment model options under two paths. The new models build on the experience of the Medicare Shared Savings Program and Next Generation Accountable Care Organization model.

A new proposed rule would increase inpatient operating payment rates by 3.2 percent and make other changes to Medicare payment and quality reporting policies. CMS is accepting comments on the proposed rule until June 24.

The Office for Civil Rights updated its website with new guidance related to health information technology access rights under the Health Insurance Portability and Accountability Act. The guidance is particularly relevant given the push for increased patient access through third-party applications.

Hospitals in the Inpatient Quality Reporting, Prospective Payment System–Exempt Cancer Hospital Quality Reporting, and Hospital Outpatient Quality Reporting programs can view their preview reports through May 21.

The Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health Information Technology extended to June 3 the deadlines for commenting on two proposed rules related to interoperability, patient access to health information, and information blocking.

CMS finalized the Notice of Benefit and Payment Parameters for the Affordable Care Act’s health insurance marketplace and the annual letter to issuers offering plans on the federally facilitated marketplaces for plan years beginning on or after Jan. 1, 2020.

Hospitals with the greatest proportion of Medicare patients dually eligible for Medicaid had decreased readmissions penalties, according to a study in JAMA Internal Medicine.

The Centers for Medicare & Medicaid Services announced notice of intent to apply and application deadlines for a Jan. 1, 2020, start date for the Medicare Shared Savings Program.

The guidance comes in response to a recent federal court decision striking down a regulation expanding the availability of association health plans.

Utah joins a growing list of states with approval to implement Medicaid work requirements, but it is the first state to limit enrollment to individuals below the federal poverty level and implement a spending cap.

The agency on April 1 launched a long-awaited website that outlines pharmaceutical manufacturers' ceiling prices under the 340B Drug Pricing Program. A recent webinar outlines how covered entities can view this data and report 340B pricing issues.

The agency in April will randomly select nine Health Insurance Portability and Accountability Act–covered entities, including health plans and clearinghouses, for compliance reviews.

The United States District Court for the District of Columbia ruled that expanding the availability of association health plans illegally circumvents the Affordable Care Act and violates the intent of federal insurance laws.

The court ruled that the Department of Health and Human Services overstepped its authority and failed to show that work requirements would help promote the purpose of the Medicaid program

America’s Essential Hospitals encouraged the Centers for Medicare & Medicaid Services to suspend publication of the overall hospital quality star ratings until the agency addresses issues with the underlying methodology.

The recently released 2017 Quality Payment Program Experience Report includes participation and performance statistics for the Merit-based Incentive Payment System and Advanced Alternative Payment Model tracks.

The recent webinar reviewed publication of 340B Drug Pricing Program ceiling prices and the process by which covered entities can report 340B pricing issues.

The report includes recommendations on several issues of importance to essential hospitals, including hospital inpatient and outpatient services, hospital quality incentive programs, and alternatives to opioids.

The report proposes three recommendations responding to Medicaid disproportionate share hospital allotment reductions and responds to concerns about the accuracy and completeness of available upper payment limit data.

The tools and guidance aim to help states monitor and evaluate the effects of Section 1115 waiver demonstrations, including those with work and community engagement requirements and those that combat substance use disorder.

Ohio’s waiver requires beneficiaries ages 18 to 49 who are eligible through Medicaid expansion to work or participate in other community engagement activities for at least 80 hours a month.

Adjusting for social risk factors in Medicare's Hospital Readmissions Reduction Program results in decreased penalties for hospitals serving a safety-net role.

The budget plan proposes to overhaul the Medicaid program, as well as significantly change the 340B Drug Pricing Program and expand site-neutral payment policies in hospital outpatient departments.

The revised Appendix Q to the State Operations Manuals includes key changes to the immediate jeopardy definition. CMS also released updated online training and a template to assist surveyors.

Long-expected "Medicare-for-all" bill formally introduced; Congressional hearings continue to focus on rising health care costs and prescription drug prices.

Hospitals now have until March 14 to submit data for the Medicare Promoting Interoperability and Hospital Inpatient Quality Reporting (IQR) programs.

The agency posted potential changes to the star ratings program for public comment, including potential hospital peer grouping.

The Centers for Medicare & Medicaid Services updated the Promoting Interoperability Programs website with new resources for the 2019 program year. The agency also announced two calls on the recently released interoperability and patient access proposed rule.

A Centers for Medicare & Medicaid Services bulletin notes that states can cover non-opioid pain management therapies using several Medicaid authorities, including Section 1945 health home benefits, 1915(i) state plan amendments, Section 1115 demonstrations, and managed care strategies.

Hospitals in the Inpatient Quality Reporting, Prospective Payment System–Exempt Cancer Hospital Quality Reporting, and Hospital Outpatient Quality Reporting programs can view their reports through March 9.

The Emergency Triage, Treat, and Transport model for emergency ambulance services encourages treatment for Medicare beneficiaries outside the emergency department.

As initially planned, any pharmacy participating in the 340B Drug Pricing Program could have been denied rebates provided through the pharmacy benefit manager, resulting in significant cuts to 340B hospitals.

The proposals aim to increase interoperability and improve patients’ access to their health information, while reducing regulatory burden on hospitals.

In response to a request for information, America's Essential Hospitals urges the Department of Health and Human Services to ensure enforcement of the Health Insurance Portability and Accountability Act encourages care coordination and reduces regulatory burden on essential hospitals.

The report, by America’s Essential Hospitals and six other national hospital associations, highlights the importance of interoperability and outlines six pathways to ensure health information technology systems can seamlessly communicate.

Medicaid and CHIP Payment and Access Commission members unanimously approved three recommendations to mitigate the impending Affordable Care Act–mandated Medicaid disproportionate share hospital allotment reductions.

The waiver requires beneficiaries ages 19 to 49 who are eligible through Medicaid expansion to work or participate in community engagement activities for at least 80 hours a month.

Proposed provisions aim to further the Trump administration’s goals to lower premiums, increase market stability, reduce regulatory burden, and protect taxpayers.

The tool includes 2018 Qualifying Alternative Payment Model (APM) Participant and Merit-based Incentive Payment System APM status.

America's Essential Hospitals praised the administration’s efforts to streamline managed care regulations for Medicaid and the Children's Health Insurance Program, reduce regulatory burden, and increase state flexibility.

Maine and Michigan join five other states to receive approval for Medicaid work requirements; unlike most other states, Maine's work requirements will apply to both existing beneficiaries and those newly eligible through expansion.

The new report, released by a public-private task force led by the Department of Health and Human Services, outlines common cybersecurity threats to health care organizations and best practices to counter such risks.

The association urged the agency to consider the interplay of new policies with existing government programs, such as the 340B Drug Pricing Program.

The Medicare Shared Savings Program final rule creates a pathway for accountable care organizations to transition more rapidly to performance-based risk.

In a letter to state Medicaid directors, the agency shared 10 opportunities to improve service to individuals dually eligible for Medicare and Medicaid.

The waiver permits federal reimbursement for short-term stays in institutions for mental disease for individuals with substance use disorders.

The new guidance recommends that clinicians consider prescribing or coprescribing naloxone to individuals with a high risk of opioid overdose.

A new association tracker lists grants and demonstration projects available under H.R. 6, the SUPPORT for Patients and Communities Act, that will be available to essential hospitals.

The Department of Health and Human Services released a request for information on ways to modify the Health Insurance Portability and Accountability Act to improve care coordination, promote value-based care, and reduce regulatory burden on providers.

The state’s waiver initially was approved in May, but required a second approval to extend beyond Dec. 31.

The association urged the Department of Homeland Security to exclude nonemergency Medicaid benefits and low-income subsidies for Medicare Part D beneficiaries from the list of programs considered in public charge determinations.

The frequently asked questions are about a new requirement, under the fiscal year 2019 Hospital Inpatient Prospective Payment System final rule, that hospitals make public a list of their standard charges via the internet.

Seven new requirements under the National Patient Safety Goals program require hospitals to screen for suicide risk and standardize treatment procedures.

Hospitals have until Dec. 30 to preview their quality data before it is published on the Hospital Compare website in February 2019.

The U.S. District Court for the District of Columbia vacated the previous approval, saying the administration failed to adequately assess the waiver's impact on Medicaid’s core objective: to provide health care coverage for beneficiaries.

The association expressed concerns about two disparity methods developed to report readmission rates among patients with social risk factors; the deadline for comments has been extended to Dec. 14.

The final rule and advanced effective date represent a significant victory for essential hospitals.

More than 1 million eligible clinicians received a neutral or better payment adjustment in the first year of the Merit-based Incentive Payment System, one of two tracks in the Quality Payment Program.

The agency will hold educational webinars to help health care providers understand the new user interface for Hospital Compare preview reports.

America’s Essential Hospitals urged the agency to promptly finalize its proposal to move up to Jan. 1, 2019, the effective and implementation date for a final rule on the calculation of ceiling prices for drugs purchased through the 340B Drug Pricing Program.

America’s Essential Hospitals highlighted the unique role essential hospitals play in treating individuals with social risk factors.

America’s Essential Hospitals encouraged the agency to continue its efforts to reduce regulatory burden at essential hospitals, including through refining Medicare and Medicaid conditions of participation.

Senators of both parties and House Republicans last week began elections for leadership positions in the 116th session of Congress; after the Thanksgiving holiday, lawmakers will continue work to approve a spending bill by Dec. 7.

A new demonstration opportunity, which can be carried out through Section 1115 waivers, would allow states to receive reimbursement for services at institutions for mental disease for individuals with serious mental illness or serious emotional disturbance.

The proposed rule reflects the agency’s broader strategy to relieve regulatory burden, support state flexibility, and promote transparency and innovation in the delivery of care.

The long-delayed final rule on the calculation of ceiling prices in the 340B Drug Pricing Program, as well as civil monetary penalties on manufactures who knowingly overcharge, will go into effect Jan. 1, 2019.

Wisconsin is the fifth state to receive approval to incorporate work and community engagement requirements as a condition of Medicaid eligibility.

The Medicare Outpatient Prospective Payment System final rule for calendar year 2019 broadens the scope of cuts to hospitals in the 340B Drug Pricing Program and to off-campus provider-based departments; in a statement, the association strongly objected to these additional payment cuts.

The rule includes updates to the Quality Payment Program and documentation and payment changes for evaluation and management services.

The agency seeks stakeholder feedback on two disparity methods measuring patient outcomes based on social risk factors; comments are due Dec. 14.

President Trump signed long-awaited bipartisan legislation to combat the opioid epidemic; the law does not align confidentiality regulations for substance use disorder treatment records with HIPAA privacy standards.

The five-year demonstration, beginning in 2020, would be open to hospitals and physicians in selected geographic areas representing 50 percent of Medicare Part B spending on separately payable drugs.

The Maternal Opioid Misuse model will last five years and support the integration of clinical care with other services critical for health, well-being, and recovery for pregnant and postpartum Medicaid beneficiaries.

In its comments, the association encouraged OIG to narrow the application of anti-kickback statute and beneficiary inducements civil monetary penalty laws to promote value and care coordination.

The guidance allows states additional flexibility to waive certain provisions of the Affordable Care Act while preserving access to affordable, comprehensive coverage.

This nine-month program enhances the advocacy skills of government relations professionals at hospitals with a mission to serve vulnerable people and communities; apply by Dec. 14.

The expansion is expected to give up to 400,000 additional Virginians access to the program; the Centers for Medicare & Medicaid Services has not announced a decision on the state's Section 1115 waiver, which includes work requirements.

America’s Essential Hospitals and six other hospital groups urged Health and Human Services Secretary Alex Azar to refrain from adding health information exchange requirements to the Medicare and Medicaid Conditions of Participation.

America's Essential Hospitals encouraged the Centers for Medicare & Medicaid Services to promote stability in the Medicare Shared Savings Program and allow essential hospitals more time to stay in savings-only tracks.

The association strongly encourages essential hospitals to submit individual comments with specific examples of how your institution addresses social risk factors among Medicare beneficiaries; comments are due Nov. 16.

The Centers for Medicare & Medicaid Services is waiving program requirements and suspending enforcement activities in Florida and Georgia.

Participating entities, including 832 acute-care hospitals, will receive bundled payments for certain episodes of care to promote value in care delivery.

The agency will publish accrediting organization (AO) performance data, redesign AO validation surveys, and share its annual report to Congress.

The Oct. 15 webinar will review how to use the new Medicare Cost Report e-Filing system to submit cost reports for fiscal years ending on or after Dec. 31, 2017.

A new notice makes technical and typographical corrections to the fiscal year 2019 Inpatient Prospective Payment System final rule.

The frequently asked questions clarify the type and format of information that hospitals must post under new requirements finalized in the fiscal year 2019 Inpatient Prospective Payment System rule.

The proposal differs from a previously leaked version and expands the list of public programs for consideration in a public charge determination.

Cooperative agreements with seven organizations aim to develop, improve, update, or expand quality measures for Medicare’s Quality Payment Program.

America’s Essential Hospitals urged the Centers for Medicare & Medicaid Services to reverse policies that will result in significant funding cuts to essential hospitals and hinder access to care.

The Sept. 26 webinar will review requirements for submitting value-based payment approaches as an Other Payer Advanced Alternative Payment Model under the Medicare Access and CHIP Reauthorization Act of 2015.

This funding supports initiatives under the agency's Five-Point Opioid Strategy and was distributed in conjunction with Prescription Opioid and Heroin Epidemic Awareness Week.

Essential hospital staff are invited to provide feedback on overall hospital quality star rating methodology during an Oct. 4 listening session; the Centers for Medicare & Medicaid Services will use the feedback to inform future methodology updates.

The Centers for Medicare & Medicaid Services waived program requirements in Virginia, North Carolina, and South Carolina; the Centers for Disease Control & Prevention issued guidance for treating carbon monoxide poisoning in hurricane victims.

The association urged the Centers for Medicare & Medicaid Services to adequately reimburse off-campus, provider-based departments and refine physician quality reporting to account for costs of care and the unique needs and patient populations served by essential hospitals.

New data show 472 accountable care organizations in the Medicare Shared Savings Program cared for 9 million program beneficiaries in 2017.

New resources from the Department of Health and Human Services’ Healthcare Cybersecurity and Communications Integration Center outline new hacking and malware threats and prevention techniques.

Covered entities that fail to complete recertification by the deadline will be removed from the 340B Drug Pricing Program for a minimum of one quarter.

The hospital-specific reports, available for download through Sept. 24, use dual eligibility as the social risk factor for stratification of readmission rates within a hospital and enable comparison of differences across hospitals.

The toolkit includes strategies and examples to help Medicaid agencies prepare for and respond to natural and man-made disasters.

Leaders of the House Committee on Energy and Commerce and the Senate Committee on Health, Education, Labor, and Pensions expressed concern that the Health Resources and Services Administration is not using its existing authority to ensure proper management of the 340B Drug Pricing Program.

In its response, the association encouraged federal regulators to revisit the Stark law with an eye toward easing barriers to care coordination and reducing regulatory burden.

The Integrated Care for Kids (InCK) Model seeks to target physical and behavioral health needs through prevention, early identification, and treatment.

The letter marks the first time the Centers for Medicare & Medicaid Services has clearly described its budget neutrality calculation and represents its attempts to streamline the waiver process and control costs.

The new guidance outlines the types of rules association health plans must follow under the Employee Retirement Income Security Act and reiterates that states and the Department of Labor have a joint responsibility to regulate such plans.

In an Aug. 16 bulletin, the agency announced it has decreased approval times for state plan amendments and Section 1915 waivers through a process improvement strategy and will continue efforts to streamline the waiver approval process.

The agency will not convene a proposed task force to reduce environmental risks associated with the care of psychiatric inpatients, opting instead to use findings from The Joint Commission special report on suicide prevention in health care settings.

A new proposed rule would create a pathway for accountable care organizations to more rapidly transition to performance-based risk.

The confidential reports, available Aug. 24, will allow hospitals to review two disparity methods that assess performance for patients with social risk factors.

Under the final rule , short-term, limited-duration insurance plans can be issued for up to 12 months, with a maximum duration of 36 months after renewals and extensions.

The special open-door forum aims to educate prescribers on federal resources and strategies to combat the opioid epidemic.

The final rule increases Medicare inpatient payment rates to acute care hospitals by 1.85 percent, revises electronic health record requirements, and changes the payment adjustment methodology for the Hospital Readmissions Reduction Program.

Hospitals have until Aug. 25 to preview their quality data before publication on the Hospital Compare website in October.

Senate action on opioid legislation has been delayed by the debate over the Supreme Court nomination and what to include in the final package; Majority Leader Mitch McConnell said senators likely will consider opioid legislation after the August recess.

The waivers allow each state to create a reinsurance program to lower premiums in the individual market; the waivers will take effect in 2019 and are approved through 2023.

A new proposed rule for Medicare’s Outpatient Prospective Payment System would broaden the scope of cuts to hospitals in the 340B Drug Pricing Program and to off-campus provider-based departments; it also contains provisions related to quality reporting and transparency.

Hospitals will have until Sept. 12 to complete the recertification process through the Office of Pharmacy Affairs Information System.

In the rule, the Centers for Medicare & Medicaid Services continues a policy of reduced payments to new off-campus provider-based departments; the agency also provides updates to the Quality Payment Program.

The Centers for Medicare & Medicaid Services extended to Aug. 8 the participation agreement deadline for the Bundled Payments for Care Improvement Advanced model and announced that participants can retroactively withdraw from the program in March 2019.

The project would waive Merit-based Incentive Payment System requirements for clinicians who participate in certain Medicare Advantage plans that involve taking on risk to better align such plans with fee-for-service Medicare.

Merit-based Incentive Payment System participants can request a targeted review of their performance feedback and final score if they find an error in their 2019 payment adjustment calculation.

The decision strikes down the state's overall Section 1115 waiver, which included community engagement and work requirements, but it upholds as a separate waiver a portion allowing Medicaid reimbursement for substance use disorder treatment in institutions for mental disease.

Several new or enhanced Centers for Medicare & Medicaid Services initiatives are designed to improve Medicaid program integrity and sustainability through greater transparency and accountability, strengthened data, and innovative analytical tools.

CMS approved Oklahoma's proposal to advance Medicaid value-based arrangements with drugmakers in negotiating supplemental rebate agreements; The agency rejected Massachusetts' request to institute a closed formulary for Medicaid outpatient prescription drugs.

America's Essential Hospitals urged the Centers for Medicare & Medicaid Services to implement its Medicare disproportionate share hospital payment methodology and quality measurement programs in a way that accounts for the unique needs and patient populations served by essential hospitals.

The brief reviews each type of Medicaid hospital payment, information on payment goals, and state-level data on fiscal year 2016 supplemental payments to hospitals.

A change brought by passage of the 21st Century Cures Act will ensure coverage for early and periodic screening, diagnostic, and treatment services for children under age 21 receiving inpatient psychiatric hospital services.

The report provides updates on the Hospital Readmissions Reduction Program, off-campus emergency department access, the physician fee schedule, population-based quality measures and incentives, and Medicare accountable care organizations, among other topics.

Medicare-eligible hospitals have until July 1 to apply for exception—and avoid a negative payment adjustment—for the 2019 payment adjustment year.

This year's Medicaid and CHIP Payment and Access Commission report focuses on the high cost of prescription drugs and the opioid epidemic.

The Department of Labor has issued a final rule expanding the definition of "employer" for purposes of establishing association health plans.

Modeled on a program developed at essential hospital St. Joseph's Regional Medical Center, in Paterson, N.J., the Alternatives to Opioids bill is one of 25 opioid-related bills the House passed last week.

This finalized rule provides flexibility in determining episode spending for Comprehensive Care for Joint Replacement model participating hospitals affected by a major disaster, such as a hurricane or wildfire.

A blog post and road map highlight the agency's approach to the crisis, including prevention of new opioid use disorder cases and use of data to target prevention and treatment.

An informational bulletin outlines the role of Medicaid in the care of infants born with neonatal abstinence syndrome, while a letter to state Medicaid directors offers guidance on funding Medicaid technology to combat the opioid crisis.

The June 19 webinar will explore the 2016 final rule on emergency preparedness requirements for Medicare- and Medicaid-participating health care providers, along with 1135 waivers.

The first Medicaid and Children’s Health Insurance Program scorecard is intended to increase public transparency and accountability in the two programs.

This is the latest of several delays of a rule that provides guidance on the calculation of ceiling prices and imposes civil monetary penalties on manufacturers who knowingly exceed them.

To ensure Medicaid beneficiaries' access to quality care, America's Essential Hospitals urges CMS not to issue access monitoring review exemptions to states with high managed care penetration.

The dashboards, which show spending for drugs purchased in Medicaid and Medicare Parts B and D, for the first time include data on year-over-year price increases for individual drugs.

The association urged the Health Resources and Services Administration to immediately implement a final rule establishing the calculation of ceiling prices and imposing manufacturer civil monetary penalties.

The plan cites and builds on proposed changes to the 340B Drug Pricing Program in the president’s fiscal year 2019 budget, as well as damaging cuts implemented through the calendar year 2018 Outpatient Prospective Payment System final rule.

The interagency effort targets obstacles to health care, including a fragmented delivery system and lack of specialty service access, faced by many rural communities.

New Hampshire is the fourth state to receive approval to incorporate work and community engagement requirements as a condition of Medicaid eligibility.

Hospitals have until June 2 to preview their quality data before it is published on the Hospital Compare website in July.

The proposal would delay by an additional year implementation of a final rule on ceiling prices and manufacturer civil monetary penalties in the 340B Drug Pricing Program.

Two new fact sheets clarify the application of privacy regulations under 42 CFR Part 2, a longstanding rule dictating how to share patient data related to substance use disorder.

The refresh includes data for the Hospital Inpatient Quality Reporting, Prospective Payment System–Exempt Cancer Hospital Quality Reporting, and Hospital Outpatient Quality Reporting programs.

The plan is required by the 21st Century Cures Act and is meant to improve federal and state coordination around the enforcement of parity laws.

A new proposed rule for Medicare’s Inpatient Prospective Payment System for fiscal year 2019 would increase inpatient operating payment rates by 1.75 percent.

The new model would allow providers to contract directly with patients, rather than contracting with Medicare or private insurers; comments are due May 25.

Clinicians eligible for the Merit-based Incentive Payment System can receive Improvement Activity credit for participating in a study on quality reporting burdens; applications are due April 30.

The webinar, intended for Medicare Part A providers, will include a presentation on the new Medicare Cost Report e-Filing system followed by a question-and-answer session.

Unlike previous data releases, this version of the tool allows users to view trend lines of the available metrics and health services areas.

The April 18 webinar will explain the benefits of voluntary submission in calendar year 2018, share reporting resources, and answer attendee questions.

The Centers for Medicare & Medicaid Services offers details on how Medicare Advantage plans might be affected by reimbursement reductions in the calendar year 2018 Outpatient Prospective Payment System final rule.

Providers who submitted data through the Quality Payment Program website can review preliminary performance feedback. Final scores and feedback will be available July 1.

The reports provide estimated hospital-level proportions of dual-eligible patients, peer group assignments, and payment adjustment information using the program's new stratified methodology.

Reports by the National Academy of State Health Policy and the Medicaid and CHIP Payment and Access Commission point to new trends, including increased focus on reform, new financing mechanisms, and standardized evaluation.

Hospitals have until Aug. 22 to petition the Centers for Medicare & Medicaid Services for inclusion on the list for the 2020 plan year.

A new analysis suggests specialty hospitals receive higher star ratings from the Centers for Medicare & Medicaid Services than major teaching hospitals by reporting fewer quality measures.

The proposed rule would exempt states with high Medicaid managed care penetration from Medicaid access to care guidelines; 17 states currently meet the proposal's exemption requirements. America’s Essential Hospitals is analyzing the proposed rule and will provide written comment to CMS.

The three-pronged approach aims to reduce drug demand, cut off the flow of illicit drugs domestically and internationally, and expand opportunities for proven addiction treatments.

In its annual report to Congress, the commission also recommends curbing Medicare Advantage plan consolidation and evaluating telehealth services before including them in coverage.

This year's report includes the commission’s statutorily required annual analysis of Medicaid disproportionate share hospital payments, as well as chapters on Medicaid managed care and telehealth.

A federal court in Washington, D.C., vacated a final rule requiring Medicaid disproportionate share hospital limit calculations to include Medicare and commercial insurance payments; the court explicitly issued a decision with nationwide impact.

The new resources for Medicare-eligible hospitals and critical access hospitals include details about submitting data through QualityNet and information on clinical quality measures.

In a March 6 comment letter, America's Essential Hospitals urged federal officials to ensure association health plans have proper oversight and cover all necessary services for beneficiaries.

Under the approved waiver, Arkansas Medicaid beneficiaries ages 19 to 49 beginning June 1 must work or participate in community engagement activities for 80 hours per month to maintain their eligibility.

The Centers for Medicare & Medicaid Services has issued a frequently asked questions document about the new voluntary bundled payment model ahead of the March 12 deadline for applications.

Medicare-eligible hospitals and critical access hospitals now have until March 16 to submit attestation data and electronic clinical quality measure data.

The proposal extends to one year the maximum length of short-term, limited duration plans — up from three months, as mandated by the Affordable Care Act.

The Centers for Medicare & Medicaid Services is giving up to 10 states the opportunity to participate in the program to design, develop, and implement value-based payment approaches.

A federal court in Missouri ruled that the Centers for Medicare & Medicaid Services’ April 2017 third-party payer DSH final rule is unenforceable. This decision is the first to invalidate the final rule.

Group reporting through the Centers for Medicare & Medicaid Services web interface must be completed by March 16; all other Merit-based Incentive Payment System data must be submitted by March 31.

Senate Finance Committee leadership sent a letter to stakeholders requesting information on Medicare and Medicaid policy options that could be used to combat the opioid epidemic.

The Centers for Medicare & Medicaid Services is awarding $8.1 million in targeted funding to assess and potentially alter states’ essential health benefits packages.

The table identifies which alternative payment models (APMs) are designated as Advanced APMs under the Quality Payment Program or the Merit-based Incentive Payment System.

The live session, on Feb. 8, will provide information on the upcoming transition to the QualityNet Secure Portal for hospitals participating in the Medicare Electronic Health Record Incentive Program.

The Centers for Medicare & Medicaid Services approved Indiana's request to incorporate work requirements in their Section 1115 Medicaid expansion waiver. This is the second waiver with work requirements approved by CMS.

The new cards will have a Medicare beneficiary identifier to replace the existing health insurance claim number, which was based on the beneficiary’s Social Security number.

Hospitals have until March 2 to preview their quality data before it is published on the Hospital Compare website in April.

The designation allows federal health agencies to allocate resources and hire specialists to combat the opioid crisis. The original declaration was set to expire on Jan. 23.

The agency expects to release comprehensive ligature risk interpretive guidance later this year for psychiatric units of acute-care hospitals and psychiatric hospitals.

The Centers for Medicare & Medicaid Services will audit mid-build certifications this year and should complete all audits by December 2018.

The Centers for Medicare & Medicaid Services announced the community engagement initiative, often referred to as work requirements, in a Jan. 11 letter and a frequently asked questions document.

The Centers for Medicare & Medicaid Services will host an information session and a series of four webinars in the coming weeks to provide information on new opportunities for states.

This year, there are 124 new participants, including 55 that will take part in the risk-baring Medicare Shared Savings Program Track 1+ model; Accountable care organizations now serve 10.5 million Medicare patients, up 1.5 million from 2017.

Researchers discovered two techniques, known as Meltdown and Spectre, that can circumvent data protections and potentially expose data on many computers purchased over the past decade.

The new rule is intended to improve care coordination and better align current rules with the Health Insurance Portability and Accountability Act.

The new system streamlines quality reporting through one portal; the data submission period runs from Jan. 2 to March 31.

The guidance defines courtesy discounts, defines when a bad debt is "written off," provides clarity about unpaid coinsurance and deductibles, and more.

The waiver extensions fund Texas' uncompensated care pool and delivery system reform incentive payment program and provide family planning services for low-income individuals in Mississippi for 10 years.

In response to an annual update to the Quality Payment Program, the association called for increased flexibility and risk adjustment for socioeconomic factors.

The final tax deal includes the repeal of the Affordable Care Act's individual mandate, Advance Refunding Bonds and Private Activity Bonds.

Hospital staff participating in the Medicare Electronic Health Record Incentive Program will learn how to register, attest, and submit measures using the QualityNet Secure Portal.

Hospitals serving low-income, underserved patients have until Dec. 22 to submit a petition for inclusion on the Centers for Medicare & Medicaid Services’ final 2019 essential community provider list.

Republican leaders hope to introduce the final tax reform bill early next week; a bill to stop cuts to the 340B Drug Pricing Program has 130 cosponsors.

The association emphasized access to essential community providers within qualified health plan networks in its comments on the 2019 draft letter to issuers.

Tax reform legislation heads to a House-Senate conference committee. Meanwhile, a bill to delay Medicaid disproportionate share hospital payment cuts could be included in year-end legislation.

The calendar year 2019 draft letter to plans offered through federally facilitated marketplaces also provides deadlines for qualified health plan certification.

The association encouraged the Centers for Medicare & Medicaid Services to ensure that state plans cover essential health benefits and include sufficient access to essential community providers.

The legislative priorities include a health care extenders package, tax reform, and a long-term funding bill. Also, bipartisan House legislation to halt 340B payment cuts now has more than 50 cosponsors.

The proposed rule increases flexibility for Medicare Advantage plans and implements the Comprehensive Addiction and Recovery Act of 2016.

The guidance specifies rate reductions in Medicaid fee-for-service that will not require access reviews by the Center for Medicare & Medicaid Services.

The House passed the Tax Cuts and Jobs Act; the Senate version of the tax reform bill includes a repeal of the Affordable Care Act's individual mandate.

In response to the request for information, the association encouraged flexibility and a focus on hospitals treating high numbers of complex patients.

Hospitals that contract with or are owned by state or local government must now identify a government official to attest to the hospital's classification.

The new guide will help patients understand their mental and behavioral health, navigate treatment options, and find appropriate services.

The Centers for Medicare & Medicaid Services will review December 2017 methodology enhancements and their impact on star ratings in a Nov. 30 webinar.

The updated standards focus on collaboration between health care providers and emergency management officials in the community.

In a speech to the National Association of Medicaid Directors, Administrator Verma also announced an initiative to create scorecards for Medicaid and CHIP outcomes.

The Quality Payment Program combines and replaces three separate clinician quality programs with a single system for clinicians that bill Medicare Part B.

The rule includes additional cuts to new off-campus, provider-based departments (PBDs), as well as physician payment and quality program changes.

Due to technical difficulties, the new 340B recertification period will run through Dec. 6; hospitals that already started the process must restart.

An agency bulletin instructs states on how to seek approval for state-directed payment arrangements and distinguishes directed payments from other payment models.

In a Nov. 2 Federal Register notice, the Centers for Medicare & Medicaid Services posted final DSH allotments for FY 2015 and preliminary allotments for FY 2017.

CMS announced a new streamlined process to encourage state innovation through demonstrations and approved new demonstrations for New Jersey and Utah.

The rule cuts 340B Drug Pricing Program payments by $1.6 billion and requires hospitals to use modifiers to identify 340B drugs in Medicare claims.

The Centers for Medicare & Medicaid Services previously had extended the revision deadline to Oct. 31, following numerous changes to the worksheet S-10.

The emergency declaration expands telemedicine services to treat addiction and opens up the Public Health Emergency Fund, among other actions to combat the opioid crisis.

The quality measure data update excludes Hospital Compare overall star ratings, which will refresh beginning Nov. 3.

A bipartisan Senate bill would fund cost-sharing reduction payments; Congress has yet to renew funding for the Children's Health Insurance Program.

America's Essential Hospitals has compiled relevant immigration resources to inform essential hospitals about the rights of patients and providers.

In its comments, America’s Essential Hospitals recommended that CMS finalize the cancellation of the mandatory episode payment models, work with stakeholders to develop voluntary models, and more.

The five-year demonstration project, beginning Jan. 1, 2018, aims to strengthen substance use disorder care for state Medicaid beneficiaries.

The Centers for Medicare & Medicaid Services' frequently asked questions document clarifies aspects of the Mental Health and Substance Use Disorder Parity final rule for Medicaid and the Children’s Health Insurance Program.

The document explains hospital payment adjustments under the Medicare Electronic Health Record Incentive Program; adjustments are applied as a reduction to the hospital Inpatient Prospective Payment System percentage increase for FY 2018.

Hospitals will have until Nov. 21 to complete the recertification process through the new Office of Pharmacy Affairs Information System.

America's Essential Hospitals opposed the proposed payment model, which would have reduced Medicare payments to providers for Part B drugs.

Hospitals have until Oct. 31 to preview their quality data; CMS hospital-specific preview reports for overall quality star ratings will be available to hospitals in mid-October.

The emergency operations center was activated in January 2016 to respond to the harmful effects of the virus when contracted during pregnancy.

Hospitals use the worksheet S-10 to submit uncompensated care data to the Centers for Medicare & Medicaid Services; the agency will begin using the worksheet to calculate Medicare disproportionate share hospital payments in fiscal year 2018.

The Centers for Medicare & Medicaid Services did not receive any letters of intent for the 2018 start date of the Medicare-Medicaid accountable care organization model.

The Centers for Medicare & Medicaid Services will conduct field testing from Oct. 16 to Nov. 15 of eight episode-based cost measures for the Merit-based Incentive Payment System.

The harmful payment reduction was included in the 2018 Outpatient Prospective Payment System proposed rule, expected to be finalized this fall.

Clinicians can participate in the first year of the Merit-based Incentive Payment System and avoid a negative payment adjustment if they begin collecting data by Dec. 31.

America's Essential Hospitals was among those urging the agency to suspend overall star ratings and examine concerns with the methodology.

The most recent delay to July 2018 comes after the Health Resources and Services Administration issued a proposed rule seeking feedback from stakeholders.

The new directive applies to Chad, Iran, Libya, North Korea, Somalia, Syria, Venezuela, and Yemen, but the specifics vary by country.

Providers can register a new entity or contract pharmacy through the 340B Office of Pharmacy Affairs Information System through Oct. 16.

The committees were convened at the direction of the Department of Health and Human Services and include representatives from members of America’s Essential Hospitals.

CMS is seeking broad feedback on a new direction for the Centers for Medicare & Medicaid Innovation, with increased emphasis on patient-centered care and market-based reforms.

Affected providers will be exempt from reporting provisions of the Medicare Hospital Outpatient Quality Reporting Program, Hospital Inpatient Quality Reporting Program, and Ambulatory Surgical Center Quality Reporting Program.

The component enables manufacturers and covered entities to register for the 340B Drug Pricing Program, participate in annual recertification, and communicate with the Office of Pharmacy Affairs on pending tasks.

Merit-based Incentive Payment System–eligible clinicians and groups may apply for hardship exceptions due to connectivity issues or extreme circumstances, such as disasters.

The meeting came a day after the association submitted comments to the agency in response to the proposed annual update of the Hospital Outpatient Prospective Payment System.

The proposed rule would further cut payments to non-excepted provider-based departments to 25 percent of the Medicare Outpatient Prospective Payment System rate and change certain quality reporting requirements.

The Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, and other federal agencies have released several resources to help health care providers prepare for and respond to disasters.

The online course provides an overview of disaster preparedness and skills to gauge compliance with emergency preparedness requirements that go into effect on Nov. 15.

The Sept. 13 webinar for covered entities will focus on the registration component of the new Office of Pharmacy Affairs Information System.

The Centers for Medicare & Medicaid Services is granting exceptions under certain Medicare quality reporting and value-based purchasing programs to hospitals and health care facilities in Federal Emergency Management Agency–designated major disaster counties.

The changes include optimizing the assignment of star categories, eliminating the removal of outliers, and ensuring only hospitals meeting public reporting thresholds are assigned star ratings.

The proposed reductions are set to take effect Oct. 1; the association recommended the Centers for Medicare & Medicaid Services protect state disproportionate share hospital payment allotments from total elimination, among other suggestions.

Substantial cuts to Medicaid disproportionate share hospital payments are set to begin on Oct. 1; strong and immediate input from essential hospitals is vital to successfully secure another delay.

Nearly half of U.S. health care breaches in July were caused by hacking, marking the first time this year that hacking incidents outnumbered insider breaches in both frequency and number of affected patient records.

In response to a proposed annual update to the Quality Payment Program, America’s Essential Hospitals offered recommendations related to the merit-based incentive payment system.

The Health Resources and Services Administration is seeking comments on whether to further delay implementation of a final rule on ceiling prices and civil monetary penalties in the 340B Drug Pricing Program by nine months.

The newly released set of frequently asked questions relates to potential payment issues for Medicaid managed care patients in institutions for mental disease.

The first performance year was set to begin Jan. 1, 2018; America’s Essential Hospitals previously expressed concern about the scope and pace of the models.

The change aims to simplify data reporting for hospitals, as most already use the QualityNet portal for communications and quality data exchange.

The system will be unavailable from Aug. 15 until mid-September; hospitals are urged to verify contact information for authorizing officials and primary contacts in the system before Aug. 14.

Exceptions are available for Merit-based Incentive Payment System eligible clinicians and groups that experienced insufficient internet connectivity, uncontrollable circumstances, or other issues; applications are due Oct. 1.

The decision extends by five years the state's demonstration of a capitated Medicaid managed care program and a low-income pool to provide support for the safety net.

The announcement to allow revisions to fiscal year (FY) 2014 worksheets is important because the agency will use FY 2014 data to calculate FY 2018 Medicare disproportionate share hospital compensation.

The final rule updates Medicare inpatient rates to acute care hospitals by 1.21 percent, provides flexibility in reporting of electronic clinical quality measures, and changes the payment adjustment methodology for the Hospital Readmissions Reduction Program.

Expanded Medicaid access under the Affordable Care Act might have helped patients seek treatment for behavioral health issues, which disproportionately affect low-income populations.

The Hospital Compare refresh includes data on new measures; hospitals can preview their overall star ratings through Aug. 13.

The delay allows for implementation of a new online tool that will allow providers to register and recertify 340B sites and contract pharmacies.

A publicly released set of slides describes dramatic restrictions to CMS' budget neutrality policy for Section 1115 waivers.

The Centers for Medicare & Medicaid Services will allow hospitals to submit revisions to Worksheet S-10 of their Medicare cost report for fiscal year 2015 by Sept. 30.

Of the 303 performance measures submitted during the trial period, 65 were determined to have a conceptual basis for adjustment for social risk factors.

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.

The Medicare Physician Fee Schedule proposed rule for calendar year 2018 includes physician payment and quality program changes.