Medicare & Medicaid

Insurers are now required to pass along price concessions received from pharmacies at the point of sale.

A central concern about capitated payments is the potential to deny both access and payments in an attempt to increase profits, OIG says.

Standardized plan options will be required at every network type and at every metal level starting in 2023. 

<p class="MsoNoSpacing"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif">This week's top stories include Physician Partners of America agreeing to pay $24.5M to settle a number of alleged violations, including unnecessary testing, and CMS estimates that payments to acute care hospitals will increase in 2023 by $1.6B. </span></span></p>

The Hospital Inpatient Prospective Payment System proposed rule is expected to increase hospital payments by $1.6B.  

After a $1 billion loss last year, the company will no longer offer individual or family plans in six states.

HRSA is training 13,000 community health workers; applications are due June 14.

HHS and the Biden Administration say they will give 60 days prior notice before ending the PHE.

The current public health emergency ends on April 16, but HHS has promised providers 60 days notice.

The American Society for Radiation Oncology has long expressed concerns about the model's reimbursement structure.