Noteworthy News

Archive for March, 2018

 

Tackling Social Determinants of Health

The growing awareness of the impact of social determinants of health comes at a time when health care providers are assuming unprecedented degrees of risk for the health of their patients, leaving many providers wondering how best to invest resources that will meet both their own needs as well as the needs of their high-cost, high-need patients. A new document from the Commonwealth Fund, “Investing in social services as a core strategy for healthcare organizations:  Developing the business case,” seeks to serve as a manual for providers seeking to move into this relatively new territory. The report takes providers through [&hellip

340B Program Getting the Job Done

The oft-scrutinized section 340B prescription drug discount program is doing what the program is supposed to do, according to a new analysis published on the Health Affairs Blog. According to the report, 340B DSHs treat significantly more low-income patients than non-340B hospitals, provide a disproportionate amount of the nation’s uncompensated and unreimbursed care, and are more likely to provide specialized services that are critical to low-income patients but which are often underpaid. In addition, 340B …has saved billions in drug costs while providing free or discounted care to millions of patients who might otherwise be unable to get needed care. [&hellip

CMS Proposes Easing Medicaid Access Requirement

Under a new regulation proposed by the Centers for Medicare & Medicaid Services, some states would no longer need to analyze access to care for their Medicaid population. In a newly proposed regulation, CMS calls for eliminating the need for such a review in states with a high degree of Medicaid managed care penetration – 85 percent or more – and under certain circumstances when they reduce payments to providers. According to CMS, existing regulations already enforce access requirements for Medicaid managed care plans, making a separate state obligation duplicative and unnecessary. A CMS news release accompanying publication of the [&hellip

Court Rebuffs CMS on Medicaid DSH

A federal court has rejected the manner in which the Centers for Medicare & Medicaid Services collects certain Medicaid data from states in a ruling that has potential implications for eligible hospitals’ Medicaid disproportionate share hospital payments (Medicaid DSH). In a case that challenged how CMS told hospitals to report third-party payments for Medicaid patients, the court ruled against CMS in two different ways:  first, it found that CMS had not interpreted a 2003 law in a manner consistent with congressional intent; and second, it ruled that CMS could not clarify its interpretation through a published FAQ rather than through [&hellip

Senate Committee Looks at 340B Program

The Senate Health, Education, Labor, and Pensions Committee (HELP) held a hearing last week on the 340B prescription drug discount program. The hearing was prompted by complaints from pharmaceutical companies about the discounts they are required to provide to eligible providers and by concern that hospitals are insufficiently accountable for how they use the savings they derive from those discounts to serve their low-income patients.  In addition, the Centers for Medicare & Medicaid Services recently reduced its Medicare payments to participating hospitals. During the hearing, Senate Republicans expressed support for the program but spoke of the need for greater transparency [&hellip

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