CMS announces the end of the blanket Extraordinary Circumstances Exception for quality reporting and value-based purchasing programs. HHS issues a remdesivir allocation fact sheet, and FDA approves a third influenza and COVID-19 combination diagnostic test.

In a July 6 letter, the association urged HHS to use a refined methodology that directs a portion of the remaining dollars in the Provider Relief Fund to hospitals filling a safety-net role that did not receive payment in the initial safety-net allocation.

In this second report on the topic, the agency describes three findings: there is no systematic or standard collection of social risk data; dual enrollment in Medicare and Medicaid remains a predictor of poor outcomes; and there are limited efforts to identify effective and scalable interventions.

The proclamation pauses the issuance of new non-immigrant employment-based visas until Dec. 31, 2020. The suspension excludes individuals whose entry is deemed in the national interest, including those providing care to hospitalized COVID-19 patients or conducting research on the pandemic.

The annual 340B Drug Pricing Program recertification period for hospitals will run from Aug. 17 to Sept. 14. Covered entities that fail to recertify will be removed from the program.

HHS has acquired additional remdesivir to be sold at wholesale allocation price; CDC reports declining emergency department use during the pandemic and updates its list of conditions that increase risk of serious illness from COVID-19.

A report highlights hospitalization risk factors for COVID-19, and GAO evaluates the National Disaster Medical System. FDA revokes emergency use authorizations for chloroquine phosphate and hydroxychloroquine sulfate.

In a closely split decision, the Supreme Court ruled the Trump administration unlawfully terminated the Deferred Action for Childhood Arrivals program. The decision allows an opportunity to rescind the program if the administration follows appropriate procedures.

HHS made public the 2018 Medicare cost report data sources used to determine eligibility for the $10 billion targeted safety-net allocation from the Provider Relief Fund. Hospitals had to meet three metrics to be eligible; 761 hospitals received payment.

Under the Federal Reserve Board proposal, certain hospitals and other nonprofits "of sound financial condition" prior to the public health emergency could be eligible to receive loans to help alleviate financial burden due to COVID-19.

The Department of Health and Human Services finalized a rule overhauling parts of the Affordable Care Act to remove nondiscrimination protections for transgender individuals and certain language access requirements for providing health care services to people with limited English proficiency.

New CDC guidance offers best practices to safely venture outside and begin to resume daily activities amid the COVID-19 pandemic, as well as information on using telehealth to expand access. CMS releases recommendations for non-emergent care in areas that are in Phase II of recovery.

Hospitals in the 340B Drug Pricing Program may begin using 340B drugs for patients seen at off-site locations before the hospitals officially register these clinics in the Office of Pharmacy Affairs Information System. This guidance is intended to last beyond the COVID-19 public health emergency.

HHS identified hospitals eligible for part of a $10 billion Provider Relief Fund allocation to aid safety-net providers. The agency also made public a list of total payments by state, including the number of hospitals in each state receiving a payment in this distribution.

In a letter to Senate leaders, America's Essential Hospitals outlines key legislative priorities to assist essential hospitals in the ongoing response to the COVID-19 public health emergency as Congress considers another supplemental bill.

New guidance provides details on COVID-19 lab test data reporting and flexible options for states implementing a Medicaid group for testing the uninsured.

The new options are detailed in a comprehensive table for each payment model. Notably, CMS will extend the Next Generation Accountable Care Organization model through December 2021.

CMS has issued blanket waivers and flexible options to increase hospital capacity, expand access to COVID-19 testing, promote telehealth, and augment the health care workforce. CMS is clarifying what requires usage of modifier “CR” or condition code “DR” when submitting claims to Medicare.

The Joint Commission will resume regular surveys of health care facilities; Gilead Sciences Inc. donates a second round of remdesivir to treat severe COVID-19 cases; CDC issues antibody testing guidelines.

CMS updates Medicare payment information to capture two new testing codes; FDA updates testing FAQs; CDC issues resources for reopening businesses and organizations.

The Department of Health and Human Services announced two distributions from the Public Health and Social Services Emergency Fund, known as the Provider Relief Fund: $4.9 billion for skilled nursing facilities and $500 million for Indian Health Service providers.

The president encouraged agency leaders to rescind, modify, waive, or provide exemptions from regulations and other requirements that could inhibit economic recovery in the aftermath of the COVID-19 public health crisis.

Providers have until June 3 to accept terms and conditions and submit necessary documentation to receive additional payments from the Provider Relief Fund to support providers incurring health care–​related expenses and lost revenue from response to the COVID-19 pandemic.

Early survey results from the Kaiser Family Foundation show implications of the unexpected pandemic upended previous budget projections as Medicaid enrollment is shown to grow rapidly during economic downturns and uncertainty.

CDC warns of an inflammatory syndrome in children with COVID-19. The agency also shares its serology surveillance strategy and guidance for resuming care unrelated to COVID-19.

The House approved the HEROES Act by a narrow margin. While the bill will not become law, it contains a number of provisions important to essential hospitals and for which the association will advocate in any final COVID-19 supplemental legislation.

The Centers for Medicare & Medicaid Services released its proposed fiscal year 2021 Inpatient Prospective Payment System rule, which includes payment and quality reporting provisions.

Hospitals interested in administering the donated experimental drug should contact their state health department.

HHS clarifies HIPAA rules for media; FDA tightens antibody testing rules and approves a home saliva test; the Missouri Hospital Association studies COVID-19 and race in St. Louis.

CMS issued the 2021 final notice of benefit and payment parameters rule and letter to issuers updating regulatory and financial standards for plans offered on the health insurance marketplaces. CMS provides detailed options for issuers to adopt value-based designs for marketplace plans.

Providers now have 45 days, increased from 30 days, to attest and accept the terms and conditions for payments from the Provider Relief Fund to support providers incurring health care–​related expenses and lost revenue from response to the COVID-19 pandemic.

America's Essential Hospitals expressed deep concern with the agency's ill-timed launch of the 340B Drug Pricing Program acquisition cost survey during this public health emergency.

CMS has updated its Medicaid and CHIP COVID-19 frequently asked questions (FAQ) document, which has been reorganized for greater usability. The new FAQs offer guidance on adjusting upper payment limit demonstrations, supplemental payments, and more to reflect pandemic response.

In a letter, America's Essential Hospitals urged the agency to reopen the comment period for the Medicaid Fiscal Accountability Regulation to allow stakeholders to address the proposed rule's impact, as the COVID-19 pandemic has fundamentally altered the health care and economic landscapes.

America's Essential Hospitals in a May 5 letter urged the Department of Health and Human Services to allocate $20 billion specifically to essential hospitals that serve large Medicaid and low-income patient populations, to ensure the stability of the nation’s health care safety net.

America's Essential Hospitals calls on the Health Resources and Services Administration to allow newly eligible entities and sites to immediately register and begin purchasing 340B drugs, suspend program audits, and disregard DSH payment adjustment percentage changes during the COVID-19 emergency.

A new study highlights racial disparities among COVID-19 patients; CDC updates testing and isolation guidelines and releases National Healthcare Safety Network data.

The rule requiring hospital-specific Medicaid DSH limit calculations to include payments from Medicare and commercial payers now is valid nationwide, with lower courts determining the effective date. Plaintiff hospitals filed a petition to appeal the decision to the United States Supreme Court.

This targeted allocation distributes $12 billion to 395 hospitals that provided inpatient care for 100 or more COVID-19 patients through April 10. Of that total, $2 billion is allocated to hospitals based on Medicare and Medicaid disproportionate share hospital (DSH) and uncompensated care payments.

CDC revised its testing guidance to reflect six new COVID-19 symptoms: chills, repeated shaking with chills, muscle pain, headache, sore throat, and new loss of taste or smell. HHS released a Workforce Virtual Toolkit, and CMS released a State Medicaid and CHIP Telehealth Toolkit.

Hospitals can now register as participating providers to receive reimbursement for COVID-19 testing and treatment services furnished to uninsured patients on or after Feb. 4. Participating providers can begin submitting claims May 6.

The survey will run April 24 to May 15 and requests drug acquisition costs from all hospitals participating in the 340B Drug Pricing Program, except critical access hospitals. CMS might use data collected through the survey to determine Medicare Part B drug reimbursement rates.

HHS opened the verification portal for providers to submit patient revenue data for payments from the general allocation of the COVID-19 provider relief fund. The agency also answered frequently asked questions and posted a fact sheet to aid providers requesting and attesting to receipt of payments.

The bipartisan legislation provides $484 billion in resources across the Department of Health and Human Services and the Small Business Administration, including an additional $75 billion for the Public Health and Social Services Emergency Fund for providers.

The Department of Health and Human Services announced April 22 how it will allocate more than $70 billion in COVID-19 provider relief under the CARES Act, including targeted aid for hospitals and other providers on the front lines of the pandemic.

Hospitals now have until April 25 at 3 pm ET to submit data to HHS that will inform how the agency will allocate $10 billion in COVID-19 provider relief funds in areas most impacted by the pandemic.

HHS announced additional detail on how the agency intends to distribute the COVID-19 relief fund to hospitals and other providers. HHS will allocate funds through a general approach and use a targeted approach for certain hospitals, rural providers, and Indian Health Services.

The agency provides recommendations for resuming non-essential care for services that cannot be virtually delivered and for health care systems and facilities in regions with low incidence of COVID-19.

CMS announced waivers for IPPS and long-term care hospitals; Medicare will nearly double payment for select COVID-19 tests; CDC developed a new National Healthcare Safety Network COVID-19 module.

CMS released new COVID-19 FAQs for state Medicaid and CHIP agencies, providing additional guidance on Medicaid provisions in the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security (CARES) Act. 

Congress should increase emergency funding for hospitals on the front lines of the COVID-19 epidemic, target hospitals in greatest need, adjust Medicaid to help essential hospitals, and provide other financial and regulatory relief.

HHS has distributed $30 billion of the COVID-19 provider relief fund. Providers have 30 days from receipt of their payment to complete attestation and agree to terms and services or return the payment.

New CDC guidance requires face coverings for all who enter a health care facility. HHS Secretary Azar issues FAQs on testing and reporting requirements. Federal agencies warn about scams related to COVID-19.

In an April 10 letter, America's Essential Hospitals urged the agency to target critical relief to essential hospitals, expressed concern about disbursements based on Medicare payments, and offered general metrics to identify and support providers serving Medicaid and low-income patients.

To ensure essential hospitals have proper resources to respond to the COVID-19 pandemic, America's Essential Hospitals asked the Department of Labor to clarify the emergency exception under the Fair Labor Standards Act and the 500-employee threshold of the Families First Coronavirus Response Act.

The fund, authorized by the CARES Act, intends to support providers incurring health care–related expenses and lost revenue from COVID-19 pandemic response.

Eligible health care providers now can apply for funding for information services, telecommunications services, and devices to provide telehealth during the COVID-19 pandemic.

Providers will receive direct deposits of their share of the $30 billion based on 2019 Medicare fee-for-service payments.

HHS sends rapid tests to public health labs and issues a HIPAA enforcement notice; CDC recommends cloth masks; a new OIG report details hospital challenges amid the pandemic.

The short-term COVID-19 Telehealth Program will offer $200 million in immediate relief to providers to purchase technology and device, and the three-year Connect Care Pilot Program will provide $100 million to support connected health services and technology for eligible providers.

The Centers for Medicare & Medicaid Services issued various waivers to increase hospital capacity, expand the health care workforce, eliminate certain paperwork requirements, and further promote telehealth.

America's Essential Hospitals distills recent CMS guidance on enhanced Medicaid funding for essential hospitals during the COVID-19 pandemic.

Secretary Azar requested governors allow health care providers to practice across state lines and relax scope of practice requirements.

FDA will not object to the use of improvised face masks; a CDC tool helps health care providers estimate their personal protective equipment supply.

CMS releases guidance for hospitals in quality reporting programs; CDC updates guidelines for testing and handling COVID-19 specimens.

The new waivers and flexible options are designed to increase hospital capacity, rapidly expand the health care workforce, temporarily eliminate certain paperwork requirements, and promote telehealth in Medicare.

The association calls on HHS to design a mechanism to distribute funds made available by the Coronavirus Aid, Relief, and Economic Security Act to hospitals serving vulnerable communities and complex patients and facing other challenges during this public health emergency.

The administration has issued guidance making policy changes related to Medicare payment, mandated paid leave, and hospital reporting requirements related to COVID-19.

President Trump has signed a $2 trillion package of COVID-19 aid that provides $100 billion to hospitals and other providers, averts cuts to Medicaid disproportionate share hospital (DSH) payments, suspends Medicare sequester cuts, and includes numerous other relief measures.

CMS issued a frequently asked questions document on how the agency will implement enhanced Medicaid funding to states to support COVID-19 response. The 6.2 percent increase in the Federal Medical Assistance Percentage was included in the Families First Coronavirus Response Act, made law on March 19.

As the Senate continues work on a third legislative package to address public health and economic needs during the COVID-19 crisis, House Democrats introduced an alternative that includes provisions important to essential hospitals and key changes absent in the Senate bill.

The March 20 letter details additional action needed to support essential hospitals as they respond to the pandemic. The letter also explains how essential hospitals face significant financial challenges as they work on the front lines of public health threats.

CDC recommends shelters plan for higher usage during the outbreak and consult with community leaders, local public health departments, and faith-based organizations about places to refer clients if a shelter space is full.

HHS announced new flexibility to increase coverage of Medicare telehealth services during the COVID-19 crisis. In separate guidance, HHS’ Office of Inspector General will allow providers to use a variety of audio and video communication platforms without incurring penalties under HIPAA.

CMS issues elective surgery guidance, telehealth toolkits, and information on quality reporting flexibility amid the COVID-19 pandemic; The Joint Commission suspends regular surveys.

The Health Resources and Services Administration (HRSA) has created a webpage with COVID-19 resources for providers participating in the 340B Drug Pricing Program. HRSA acknowledges 340B covered entities will need additional flexibility pertaining to program compliance during the COVID-19 crisis.

CMS issued several checklists and templates for state Medicaid and the Children's Health Insurance Program agencies to request regulatory relief and flexibility to respond to the COVID-19 outbreak.

An alert from U.S. Citizenship and Immigration Services clarifies testing, treatment, and preventive care — including a vaccine, if one becomes available — related to COVID-19 will not be considered as part of a public charge inadmissibility determination.

President Trump declared a national emergency as the number of confirmed COVID-19 cases in the U.S. nears 3,500. CMS responds to concerns about complying with Emergency Medical Treatment and Labor Act requirements and CDC released updated infection control guidance for health care providers.

America's Essential Hospitals expressed concern that a proposed drug acquisition cost survey exceeds CMS authority under Medicare statute and would impose excessive burden on hospitals in the 340B Drug Pricing Program.

The rules, intended to increase interoperability and improve patients’ access to their health information, finalize provisions related to the MyHealthEData initiative and implement provisions of the 21st Century Cures Act.

As U.S. cases of the new coronavirus rise to more than 400, the agency updates guidelines for testing patients and for health care workers exposed to COVID-19.

The new code applies to tests conducted outside CDC laboratories; CMS also issued frequently asked questions and fact sheets about COVID-19–related billing.

In a memo to state survey agencies and accrediting organizations, CMS announced it will focus survey activities solely on infection control until further notice and provided guidance for patient triage and nursing homes.

This decision is the latest of several court cases invalidating work requirements policies in Medicaid; Utah now is the only state with these requirements in effect. It is unknown at this time if Michigan or the Department of Health and Human Services will appeal the decision.

The report, mandated by the 21st Century Cures Act, highlights issues and challenges pertaining to the use of health information technology and electronic health records (EHRs) in four categories: clinical documentation; usability and the user experience; EHR reporting; and public health reporting.

These cases bring the total number of COVID-19 cases detected and confirmed in the United States to 16. The Centers for Disease Control and Prevention and the Food and Drug Administration have issued new guidance and resources to prevent the spread of the virus and improve testing.

The Supreme Court announced it will review the court decision finding the Affordable Care Act’s individual mandate unconstitutional. The case, now expected to be heard this fall with a decision likely in 2021, will determine the fate of the law.

The agency announced it will count patients repatriated by the Department of State separately from other cases. Additionally, the World Health Organization developed an emergency ICD-10 code for COVID-19.

A new proposed rule would extend the Comprehensive Care for Joint Replacement (CJR) model by three years and add outpatient knee and hip replacement to the definition of a CJR episode. Comments are due to CMS by April 24.

The Department of Homeland Security will implement its expanded definition of public charge nationwide until five district courts decide on the lawfulness of change. Meanwhile, the Department of State also will begin using the expanded definition for those seeking visas.

In a new Modern Healthcare commentary, association President and CEO Bruce Siegel explains that the proposed Medicaid Fiscal Accountability Regulation would do more to shrink Medicaid than to contribute to program integrity and transparency.

In the unanimous decision, the United States Court of Appeals for the District of Columbia Circuit found that the Department of Health and Human Services failed to adequately assess the potential impact of work requirements on coverage under Arkansas' Section 1115 demonstration waiver.

Administrator Verma writes that provisions of the Medicaid Fiscal Accountability Regulation are meant to ensure transparent and lawful use of taxpayer resources to fund Medicaid. She contends that nothing in the proposal is meant to reduce Medicaid funding or prohibit supplemental payments.

The new coronavirus — now officially called COVID-19 — has infected 15 people in the United States. The Centers for Disease Control and Prevention released new guidance for health care providers to help with risk assessment, monitoring, and work restriction decisions.

Comments on a proposed acquisition cost survey to inform Outpatient Prospective Payment System payment rates for 340B drugs are due March 9.

The proposal calls for $920 billion in cuts to Medicaid funding, including a call to finalize the Medicaid Fiscal Accountability Regulation.

The new authorization allows any CDC-qualified laboratory to use the 2019-nCoV diagnostic test. Each test kit can evaluate up to 800 patient samples.

A new rule allows CDC to require that airlines collect and provide data on passengers and crew arriving from foreign countries for health education, treatment, prophylaxis, or other public health interventions.

GAO found that state Medicaid programs did not always have written procedures to identify 340B drugs and prevent duplicate discounts. Even when states have written policies and procedures, GAO found they were not always adequate to prevent duplicate discounts.

CMS issued the 2021 notice of benefit and payment parameters proposed rule and draft letter to issuers updating regulatory and financial standards for plans offered on the health insurance marketplaces. CMS is not proposing any changes to network adequacy standards.

The agency reports that cybercriminals could send "phishing" emails purporting to include infection prevention information related to the new coronavirus (2019-nCOV) outbreak.

The Department of Homeland Security will evaluate applications for immigration benefits postmarked or submitted electronically on or after Feb. 24. The agency will not consider any newly added public benefit categories that the applicant received before Feb. 24.

CMS issued guidance outlining how states can receive a block grant or per-capita cap in exchange for additional administrative flexibility. Through a Section 1115 demonstration waiver, these new financing arrangements would apply to coverage of optional Medicaid patient populations.

In response to a joint proposal, America’s Essential Hospitals expressed concern about mandating the public posting of payer-specific negotiated rates and urged the departments of Labor, Treasury, and Health and Human Services to seek alternatives that better serve consumers.

In its submitted comments, the association outlines overarching and specific problems that necessitate withdrawal of the rule to protect the stability and viability of the Medicaid program.

CMS plans to transition to a unified Medicare Care Compare portal this spring that will combine and standardize the eight existing tools and allow a single point of entry for quality information.

This month’s data refresh is based on the existing, flawed methodology used during the last update of star ratings in February 2019.

Five cases of the coronavirus have been reported in the United States; CDC will host a Jan. 31 call for clinicians to share updated guidance about the virus.

DHS now can enforce the public charge rule everywhere but Illinois. The stay on the injunction will remain in place until the Court of Appeals for the Second Circuit makes a final decision on the merits of the government’s appeal.

Despite a growing awareness of the impact of social determinants of health on patient health outcomes, the CMS study found challenges to consistent data collection, including a lack of standardized screening tools and inconsistent use of electronic health record codes.

CMS issued a request for information seeking input on coordinating care from out-of-state providers for medically complex children who are eligible for Medicaid coverage. The agency will use the information collected to produce guidance to state Medicaid directors.

The issues are related to the validation process for Windows Elliptic Curve Cryptography certificates and the Windows remote desktop client. The Department of Health and Human Services is urging health care providers to install patches to minimize their risk.

In an amicus brief, America's Essential Hospitals joined other national hospital associations in calling for an expedited Supreme Court review of a case that will determine the future of the Affordable Care Act. The court on Tuesday denied the expedited schedule.

A panel convened by the National Institutes of Health culminated in an evidence report that includes 26 recommendations for improving implementation of proven services to reduce disparities in preventable conditions.

The statutorily required report reviews rules and oversight for institutions for mental disease in seven states. Meanwhile, CMS announced it will integrate the psychiatric hospital program survey into its larger survey to determine compliance with Medicare conditions of participation.

The recommendations come after a GAO review of more than 250 nongovernmental hospitals found several issues with how the Health Resources and Services Administrative oversees 340B program compliance.

In an informational bulletin to state Medicaid agencies, CMS provides best practices to avoid duplicate discounts on drugs purchased through the 340B Drug Pricing Program.

The new guidelines reflect revised conditions of participation in the September 2019 discharge planning and burden reduction final rules.

CMS granted a 15-day comment period extension for the Medicaid Fiscal Accountability Regulation. Comments are now due to the agency on Feb. 1, 2020.

America’s Essential Hospitals said the federal Anti-Kickback Statute and Physician Self-Referral Law should be modified to remove barriers to coordinating care for the complex patients essential hospitals serve.

Congress approved and the president signed a fiscal year 2020 spending package that delays through May 22, 2020, a $4 billion cut to Medicaid disproportionate share hospital payments.

A U.S. Court of Appeals panel upheld a ruling on the constitutionality of the individual mandate but returned the case to a lower court to decide whether that nullifies the entire law.

The agency announced awardees for two new models that seek to improve care coordination for children and for mothers with opioid use disorder.

The report is based on feedback gathered during a September listening session, in which more than 300 stakeholders shared recommendations for improving predictability, stability, and relevance of star ratings.

Through this newly approved Section 1115 demonstration waiver, South Carolina becomes the first state to apply work requirements primarily to parents and caregivers.

Beginning Jan. 1, 2020, CMS will start to adjust claims that were paid at the reduced rate. The agency also filed a notice appealing its case to the U.S. Court of Appeals for the District of Columbia Circuit.

America’s Essential Hospitals expressed concern that a proposed drug acquisition cost survey would impose excessive burden on hospitals and raise many operational challenges.

In a letter to the Department of State, America’s Essential Hospitals expressed concern that broadening the definition of public charge would harm the nation’s health care system, vulnerable patients, and state and local economies.

The agency published new requirements for hospitals to publicly post standard charges, including information based on rates negotiated with third-party payers. 

The agency proposes to increase transparency in Medicaid supplemental payments and impose more stringent requirements on those payments and their financing for states and providers.

This year’s update contains new quality and accountability measures and new national context data.

A new brief summarizes program recommendations from an expert panel, which included America's Essential Hospitals staff.

The move aims to give researchers a better understanding of key Medicaid and Children's Health Insurance Program information, including on utilization and spending under Medicaid managed care.

CMS also approved a unique behavioral health transformation waiver for the District of Columbia that targets beneficiaries with serious mental illness or serious emotional disturbance.

Health care providers have until Dec. 3 to download their preview reports, which include overall hospital quality star ratings.

The final rule includes provisions related to the Quality Payment Program, evaluation and management services, telehealth services, and the Medicare Shared Savings Program.

In a separate, forthcoming final rule, the Centers for Medicare & Medicaid Services will summarize and respond to the more than 1,400 public comments it received about proposed requirements for hospitals to make public their standard charges.

The agency seeks comment on a questionnaire to enforce its revised public charge standard for visa applicants. Separately, the department sought comment and emergency review of information collection to enforce the presidential proclamation suspending the entry of immigrants without health coverage.

The October refresh does not include an update of overall star ratings, which were last updated in February.

Applications for the new payment models are due to the Centers for Medicare & Medicaid Services Jan. 22, 2020.

The association expressed support for the Substance Abuse and Mental Health Services Administration's proposed revisions to confidentiality of records for patients with substance use disorders, while outlining remaining barriers to care coordination.

The court struck down parts of the law that explicitly prohibit discrimination based on gender identity and termination of pregnancy.

The updated resource library includes new fact sheets and guides for the Merit-based Incentive Payment System and Advanced Alternative Payment Models.

The rule intends to align the State Department’s public charge definition with the Department of Homeland Security public charge final rule.

America’s Essential Hospitals applauded the decision, noting that the rule threatens the health of millions and the stability of essential hospitals.

The guidance seeks to reduce the risk of substance use disorder while providing effective pain management for chronic pain patients.

The report includes recommendations to the Centers for Medicare & Medicaid Services for improved oversight of these waivers.

The proclamation states that the entry of immigrants who do not obtain health insurance financially burdens the health care system.

The proposed rules seek to eliminate barriers to promoting care coordination under current fraud and abuse laws; comments are due to the agencies Dec. 31.

The order directs the Department of Health and Human Services to alter the Medicare Advantage program, increase cost and quality transparency, and continue site-neutral payment policies.

External actors can exploit cybersecurity vulnerabilities in medical devices to assume control of a device and change or prevent its intended function.

Plaintiffs in the court case that resulted in the reinstatement of the third-party payer rule have filed a petition for rehearing.

The association 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 agency seeks comments until Nov. 29 on a proposal to collect acquisition cost data from hospitals participating in the 340B Drug Pricing Program.

The final rule revises conditions of participation and conditions for coverage and also targets emergency preparedness, quality reporting, infection control, and physical examination requirements.

The final rule requires hospitals to create discharge plans for all inpatients and some outpatients and excludes several burdensome requirements that were included in the proposed rule.

America’s Essential Hospitals expressed concern that changes to the Supplemental Nutrition Assistance Program could increase food insecurity and worsen health outcomes.

The methodology outlines how the agency will calculate states’ Medicaid disproportionate share hospital payment reductions and encourages states to target remaining payments to hospitals caring for the most low-income patients.

Beginning in April 2020, hospitals with multiple service locations must accurately enter the address of their off-campus, provider-based departments.

Facilities located in areas designated as emergency or major disaster areas will be exempt from provisions of Medicare quality reporting programs.

America's Essential Hospitals warns the Centers for Medicare & Medicaid Services that its proposal will weaken federal oversight of Medicaid payment rates and undermine beneficiary access to care.

The agency is waiving program requirements and suspending enforcement activities in Florida, Georgia, North Carolina, South Carolina, and Puerto Rico.

Funding will support the State Opioid Response Grant Program and a cooperative agreement to help state and local governments track overdose data.

Covered entities that fail to complete recertification will be removed from the 340B program for a minimum of one quarter.

America's Essential Hospitals urged the agency to leverage a new pilot program to expand telehealth services in communities essential hospitals serve.

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 2020 payment adjustment calculation.

The guidance follows a May 23 presidential memorandum calling for increased enforcement of laws related to individuals sponsoring immigration applicants.

Two proposed rules aim to remove barriers to care coordination and facilitate information sharing for providers treating patients with substance use disorders.

An NEJM Catalyst article assesses four public hospital quality reporting programs' ability to classify hospital performance.

The ruling reinstates a 2017 final rule requiring that audits include payments from Medicare and commercial payers when calculating the hospital-specific disproportionate share hospital funding limit.

The agency plans to update the Overall Hospital Quality Star Ratings methodology in 2021 and will host a Sept. 19 listening session to seek stakeholder feedback.

America’s Essential Hospitals expressed concern that changes to nondiscrimination protections will decrease access and worsen outcomes for vulnerable patients, including transgender individuals and individuals with limited English proficiency.

The final rule revises the criteria that determines whether an individual seeking to enter the country or become a lawful permanent resident could become a public charge.

America’s Essential Hospitals urged the Centers for Medicare & Medicaid Services to reduce administrative burden regarding clinical documentation, health information technology, and public health reporting.

To facilitate multi-payer alignment for ambulance services, the Center for Medicare and Medicaid Innovation will provide an interactive learning system with targeted learning opportunities for state Medicaid programs.

The agency will reimburse hospitals at least 65 percent of the cost for this innovative cancer treatment.

The agency now will require hospitals to submit documents supporting the hospital classification they select during 340B Drug Pricing Program registration.

The court ruled that the Secretary of Health and Human Services failed to adequately consider the effect of the work requirements on Medicaid coverage.

The rule increases inpatient operating payment rates by 3.1 percent, makes other payment and quality reporting policy changes, and estimates a $140 million increase in Medicare disproportionate share hospital payments.

The refresh includes results from the Hospital Consumer Assessment of Healthcare Providers and Systems but does not include overall star ratings.

The Medicare Outpatient Prospective Payment System proposed rule for calendar year 2020 would continue cuts to hospitals in the 340B Drug Pricing Program and to off-campus provider-based departments and introduce new transparency requirements.

The calendar year 2020 proposed rule includes updates to the Quality Payment Program, a request for information on the creation of Merit-based Incentive Payment System Value Pathways, and other topics of interest to essential hospitals.

Two informational bulletins outline information on services for infants via residential pediatric recovery centers and a limited exception to the institutions for mental disease exclusion for pregnant and postpartum women with substance use disorder.

Three essential hospitals will join the National Institutes of Health's Justice Community Opioid Innovation Network to research quality addiction treatment for opioid use disorder in jails, drug courts, and other criminal justice settings.

America’s Essential Hospitals and other national hospital associations released a report, based on interviews with hospital patient experience leaders, on modernizing the Hospital Consumer Assessment of Healthcare Providers and Systems Survey.

A Centers for Medicare & Medicaid Services report to Congress details an action plan to assist states in providing housing-related support for Medicaid beneficiaries with substance use disorders.

Covered entities can access the webinar online or via phone on Aug. 14 from 1–2 pm ET.

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.