Policy and Legislation

Immigration reform is once again being taken up in the country's capital, and depending on the final shape it takes, it could be a boon for the long-term care industry.

When the Centers for Medicare & Medicaid Services proposed, in mid-February, an additional 2.3 percent cut to the rates it pays private insurers for running Medicare Advantage plans in 2014, the reaction from America's Health Insurance Plans (AHIP) was swift, comprehensive and sustained.

By 2014, the core operating rules will likely have a major effect on reimbursement and revenue cycle processes and, as a result, payments, according to speakers who represented the payer, provider and banking perspectives at a Tuesday session titled "The Business Side of Care" during the 2013 HIMSS Annual Conference & Exhibition.

Doctor-owned hospitals are earning many of the largest bonuses from the federal health law's new quality programs, even as the law halts their growth.

As the dust settles from the Supreme Court's ruling on the constitutionality of the Affordable Care Act (ACA), the results of the presidential election and, more recently, the sequester cuts, acute care providers are now turning attention to the looming reimbursement cuts.

With the Affordable Care Act entering the home stretch of implementation, U.S. Senators are still trying to understand the costs and benefits of insurance market reforms, while diagnosing problems in the greater healthcare system.

A new report by Trust for America's Health says prevention improves health and productivity and saves billions, but is prevention really cost effective?

Among the least popular decisions handed down by the Centers for Medicare & Medicaid Services in recent years, it’s hard to top the rule requiring hospitals to rein in readmission rates or suffer the financial consequences. As most CFOs are painfully aware, those consequences include substantial reductions in reimbursements.

With no comprehensive program designed to provide long-term care insurance, a panel of experts who convened in March agreed that comprehensive reform has about a five-year window for implementation in order to sufficiently meet the needs of baby boomers.

The American Medical Association has challenged a Georgia court’s blocking of a prompt payment law and in the process has raised questions about some of the pillars of federal preemption under the Employee Retirement Income Security Act (ERISA) as it relates to third-party administrators and self-funded insurance plans.