Policy and Legislation
The Centers for Medicare & Medicaid Services recent 10-year projection of national health expenditures includes retail spending on prescription drugs, but a more complete picture of pharma spending would include the nonretail segment.
With an improving fiscal climate, some states are paying their Medicaid providers more. More states are increasing fees to specialists, nursing homes and managed care organizations, but 31 states were cutting or freezing Medicaid hospital rates, compared to 19 that were increasing them.
The medical tourism industry must respond to the problems found in surrogacy tourism. The first is the need for medical tourism companies, brokers, clinics and even hospitals to hold patient funds in escrow. Abuse of patient trust by misappropriating funds should no longer be an issue.
The 2015 Medicare Part A deductible -- for inpatient hospital, skilled nursing facility and home healthcare services -- will increase by $44 in calendar year 2015 to $1,260, while the monthly Part A premium will decline by $19. Medicare Part B monthly premiums and deductibles will remain unchanged.
Many Medicare beneficiaries treated at primarily rural "critical access" hospitals end up paying between two and six times more for outpatient services than do patients at other hospitals, according to a report released Wednesday by the HHS inspector general.
This week the Centers for Medicare & Medicaid Services expanded the agency's Five Star Quality Rating System for Nursing Homes, and proposed new conditions of participation for home health agencies.
The HHS Inspector General continues to fault CMS for failing to issue final regulations to enforce the location requirements for rural health clinics. The agency's inaction is costing taxpayers millions.
The U.S. Supreme Court has agreed to hear a case brought by Idaho providers over an issue that has split many lower courts: whether Medicaid providers have a Constitutional right to sue states to enforce Medicaid funding regulations.
Are hospitals exploiting the 340B drug discount program? Critics of the federal government's program have some new evidence in the debate over healthcare subsidies.
Rural health providers may feel burdened by a confluence of policy and financing trends. But one opportunity, depending on the state, can help with sustainability.