Significant CMS moves include withdrawal of emergency abortion care guidance
Editor's Note CMS has rescinded a 2022 guidance that protected clinicians providing emergency abortion care under the Emergency Medical Treatment & Labor Act (EMTALA), removing a key federal safeguard for providers in states with abortion restrictions, according to a June 2 article in Becker’s Hospital Review. The guidance, originally issued…
CMS takeover of 340B looms as some health systems double down on drug discount strategy
Editor's Note The federal 340B Drug Pricing Program may soon shift from the Health Resources and Services Administration (HRSA) to the Centers for Medicare and Medicaid Services (CMS), a move that could bring tighter oversight and lasting consequences for safety-net providers, Modern Healthcare June 2 reports. The proposed transfer, part…
CMS updates hospital price transparency guidelines
Editor's Note The Centers for Medicare & Medicaid Services (CMS) has updated hospital price transparency guidelines to require publishing real, calculated dollar amounts rather than placeholders and estimates. As detailed in the agency’s May 22 announcement, the revision complies with President Trump’s February 25 Executive Order 14221, “Making America Healthy…
Low-income patients billed despite hospital tax breaks
Editor's Note Nonprofit hospitals, which are legally required to provide free or discounted care to qualifying patients, attempt to collect hundreds of millions of dollars from low-income patients annually while receiving significant tax breaks meant to ensure affordable care, according to a May 12 article from CBS News. As…
CMS vision shifts as agency halts funding for state programs
Editor's Note The Centers for Medicare & Medicaid Services (CMS) will no longer approve federal matching funds for designated state health programs (DSHPs) and designated state investment programs (DSIPs) that are not directly related to Medicaid services. According to the April 10 announcement, the decision aims to preserve the core…
Renewed push for healthcare price transparency faces familiar challenges
Editor's Note Although a recent executive order from President Donald Trump aims to make hospitals and insurers reveal negotiated prices, data inconsistencies and a lack of consumer usability continue to hinder progress, according to a March 31 article from NPR. As detailed in the report, the executive order builds on…
Study compares robotic, laparoscopic cholecystectomy cost drivers
Editor's Note A retrospective review of 14 hospitals over 7 years found that robotic cholecystectomy costs were, on average, 2.5 times higher than laparoscopic cholecystectomy ($1,447 vs. $669 per case). Findings were published on March 19 in the journal Surgery. Disposable instrument choices also impact costs. Despite the rising adoption…
Trump signs executive order to enforce hospital price transparency rules
Editor's Note President Donald Trump signed an executive order to enforce healthcare price transparency regulations, according to a February 25 report in Fierce Healthcare. As detailed in the article, the order directs the Departments of Treasury, Labor, and Health and Human Services (HHS) to rapidly implement and enforce price transparency…
Understanding bipartisan push for site-neutral Medicare payments aiming to curb healthcare costs, consolidation
Editor's Note Amid growing concerns over healthcare spending and affordability, there is bipartisan interest in aligning Medicare payments for outpatient services across various care settings through "site-neutral" payments, KFF June 14 reports. As a June 2023 Modern Healthcare article explains, last year Congress reviewed legislation to expand site-neutral payment policies,…
RAND study reveals private payers pay 250% more than Medicare for healthcare services
Editor's Note A recent analysis by the RAND Corporation, a research and analysis nonprofit, revealed a disparity between hospital and ambulatory surgery center (ASC) prices paid by employers and private payers compared to Medicare prices, Revcycle Intelligence May 15 reports. The study, covering data from 2020 to 2022, showed private…
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