The 2024 election results will create significant tailwinds for Republican legislative and regulatory priorities in US Congress, federal agencies, and state houses across the country. This On the Subject considers the outlook for pharmacy regulation under the second incoming Trump administration and a unified Republican Congress, as well as state-level pharmacy policies that may advance […]
Post-Election Outlook: Pharmacy Regulation Read More »
Drug overdose deaths may be on the decline in parts of the U.S. for the first time in years, but the opioid epidemic is far from over. Contributing to the epidemic’s complexity is payers’ refusal to comply with state and federal parity laws and barriers to access medications for opioid use disorder (MOUD), according to
Payers Persistently Dodge Substance Use Disorder Treatment Mandates, AMA Report Says Read More »
The healthcare industry is anxiously awaiting a new administration under President-elect Donald Trump — and some analysts think the change in leadership could do providers’ finances more harm than good. A report published this week from S&P Global Ratings said possible changes following the election’s “red wave” are likely to have a net negative impact
How the New Trump Administration Could Hurt Provider Finances Read More »
With Donald Trump’s return to the White House and Republicans taking full control of Congress in 2025, the Affordable Care Act’s Medicaid expansion is back on the chopping block. More than 3 million adults in nine states would be at immediate risk of losing their health coverage should the GOP reduce the extra federal Medicaid
9 States Poised to End Coverage for Millions if Trump Cuts Medicaid Funding Read More »
Hospitals have expanded their legal push for the federal government to boost Medicare reimbursement. More than 500 hospitals last week sued the Health and Human Services Department for allegedly miscalculating a 40-year-old Inpatient Prospective Payment System base reimbursement rate that providers say has lowered years of subsequent Medicare payments to hospitals. The lawsuit is the
Hospitals Increase Legal Pressure to Boost Medicare Pay Read More »
A federal judge in Delaware has ordered home health and hospice provider VitalCaring and its private equity backers to share future profits with Encompass Health (NYSE: EHC) and Enhabit Inc. (NYSE: EHAB). The case has a long circuitous history that dates back to 2022 when Encompass Health spinned off its home health and hospice business
New policies tucked into the Centers for Medicare and Medicaid Services’ (CMS) 2025 Medicare Physician Fee Schedule Rule (Final Rule) will likely spur increased Accountable Care Organization (ACO) participation in the Medicare Shared Savings Program (MSSP or Program), in part due to the potential for ACOs to earn more savings and access savings sooner. The
New CMS Policies Position the MSSP for Expansion and Increased Savings Read More »
After a somewhat disappointing rulemaking cycle for ambulatory surgery centers (ASCs) this year, 2025’s discussions with federal regulators will become all the more important. And a return to a Trump administration means ASC stakeholders will need to start those conversations sooner rather than later. “We’re really going to get on the ball very early in
The past year has seen a slew of regulatory developments aimed at improving quality and combatting fraud in the hospice industry. The drive by regulators and members of Congress to strengthen oversight is fueled by two main factors. The first was two July 2019 reports on hospice quality from the Office of the Inspector General
Hospice Oversight: 2024’s Most Impactful Regulatory Actions Read More »
Spending on healthcare lobbying has ticked up in 2024, with companies and associations in the healthcare sector again spending hundreds of millions and again putting the greatest attention on bills that involve pharmacy benefit managers. According to federal data compiled by OpenSecrets and analyzed by Modern Healthcare, lobbyist spending for the first three quarters of
PBM Legislation Again Dominates Lobbying Expenditures in 2024 Read More »
