- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- Public Inspection: CMS: Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- Public Inspection: CMS: Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments; and Appeal Rights for Certain Changes in Patient Status; Corrections and Correcting Amendment
- CMS: Request for Information; Health Technology Ecosystem
- CMS: Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments; and Appeal Rights for Certain Changes in Patient Status; Corrections and Correcting Amendment
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- State: 60-Day Notice of Proposed Information Collection: J-1 Visa Waiver Recommendation Application
- HHS: Request for Information (RFI): Ensuring Lawful Regulation and Unleashing Innovation To Make American Healthy Again
- Public Inspection: CMS: Request for Information: Health Technology Ecosystem
NBC Spotlights Shortages of EMS Personnel in Rural America
In a powerful piece titled “What if You Call 911 and No One Comes?”, NBC shined a spotlight on the growing shortage of EMS personnel in rural areas across the country. The story focuses its narrative on the challenges to maintaining reliable EMS services in Hebron and Marmarth, North Dakota, but it explains that their stories are not isolated incidents. The situations in Hebron and Marmarth aren’t isolated; they come at a time when demand for health care in rural America far exceeds the supply of people necessary to provide that care. Fewer rural hospitals mean ambulances need to travel even farther distances, often in rough terrain or on unmarked roads, causing even more challenges in emergency situations.
Toolkit for Reducing Diagnostic Errors in Primary Care Pediatrics
Research from a recent American Academy of Pediatrics, Agency for Health Research & Quality (AHRQ) Improvement Innovation Network, showed that diagnoses for pediatric elevated blood pressure and adolescent depression improved and sustained with interventions developed during the project. It showed that missed or delayed actions for laboratory tests with abnormal results improved during the maintenance phase and after the intervention. The results were used to develop AHRQ’s Reducing Diagnostic Errors in Primary Care Pediatrics Toolkit.
Pharmacy Drone Delivery
After receiving approval earlier this month from the Federal Aviation Administration to operate a commercial drone fleet that will carry small metal boxes, UPS announced this week that it’s expanding drone-delivery services to include CVS Pharmacy, Kaiser Permanente, wholesale pharmaceutical distributor AmerisourceBergen and the University of Utah health system. UPS is hitting the healthcare business on all sides, from patients to providers and suppliers, for faster deliveries of lab testing, prescriptions and medical supplies. UPS expects the unmanned aircraft to cut down a 30-minute truck drive to 3 minutes and 15 seconds.
New Study Quantifies Opioids Cost to U.S. Economy at $631 Billion
The opioid crisis cost the U.S. economy $631 billion from 2015 through last year, according to a study by the Society of Actuaries. The biggest driver of the cost over the four-year period is unrealized lifetime earnings of those who died from the drugs, followed by healthcare costs. While more than 2,000 state and local governments have sued the drug industry over the crisis, the report finds that governments bear less than one-third of the financial costs. The rest are borne by individuals and the private sector.
Progress Made, Progress Lost with Covering Kids
An analysis of new census data shows the number of children in the United States without any kind of insurance rose by more than 400,000 between 2016 and 2018 after decades of progress, the N.Y. Times reports. The article indicates that there is growing evidence that administrative changes and rising fears of deportation in immigrant communities are pushing large numbers of children out of coverage under federal programs.
Pennsylvania Reaches Deal with Five Drug Companies
Pennsylvania and three other states have reached an $8 billion deal with five companies over their roles in fueling the deadly opioid epidemic, Pennsylvania Attorney General Josh Shapiro announced this week. An agreement in principle was reached with Cardinal Health, McKesson, AmerisourceBergen, Johnson & Johnson and Teva that will provide $22.25 billion in cash and another $26 billion for medication-assisted treatment drug provision and distribution over 10 years. The deal also includes North Carolina, Tennessee and Texas. The $26 billion in generic suboxone product, product distribution, and data-tracking measures will be distributed to the four states over a 10-year period. The states chose the settlements as a way to get the resources necessary to combat the opioid crisis rather than endure the delays of a lengthy court process and post-trial settlements. Still pending is a lawsuit filed last month by Shapiro against the Sackler Family, whose Purdue Pharma has been sued by states and local governments across the country for the role of OxyContin in the opioid epidemic.
Pennsylvania Releases HealthChoices RFA
On October 15, 2019,the Pennsylvaia Department of Human Services (DHS) released the Pennsylvania HealthChoices Physical Health Medicaid Managed Care request for applications (RFA). Reflecting the current framework, Medicaid managed care organizations (MCOs) will serve the five HealthChoices zones covering all 67 counties: Southeast, Southwest, LehighCapital, Northwest, and Northeast. Contracts are worth nearly $13 billion. Pennsylvania failed to implement new contracts and negated awards from 2016 as well as the awards from the 2017 rebid. As a result, the HealthChoices program is currently operating under extensions of contracts originally awarded in 2012. The most recent awards in early 2017, which would have been for a three-year, $12 billion contract, were protested by Aetna, UnitedHealthcare, and AmeriHealth Caritas, leading the state to cancel the RFA and reissue the procurement. Applications are due December 17, 2019, and contracts are expected to begin January 2021, running for five years, with an option to extend for an additional period of three years. An award date was not announced.
Pennsylvania 2020 Individual Marketplace Plan Rate Filings
Pennsylvania Insurance Commissioner Jessica Altman announced Pennsylvania’s approved 2020 individual and small group ACA health insurance rates, highlighted increased marketplace competition within several counties and noted a decrease in counties with only one carrier. Click here to see the press release. Pennsylvania will have seven insurers in the health insurance market offering individual plans for 2020.
- Ambetter
- Capital Blue Cross
- Geisinger Health Plan
- Highmark
- Independence Blue Cross
- Oscar
- UPMC
Federal Court Blocks Public Charge Rule
On October 11, 2019, two District Courts issued nationwide preliminary injunctions to stop the Trump Administration’s public charge rule, which would have taken effect Oct. 15, 2019. This proposal was opposed by NACHC, PACHC and many other organizations that expressed concern about the proposal’s impact on immigrant families and refugees. An article further explaining the ruling can be found here. A Kaiser Family Foundation study showed Community Health Centers reported that immigrant patients have declined to enroll in or renew Medicaid coverage out of fear of becoming a public charge, even those patients who are not covered by this rule.
Pennsylvania Department of State Unveils New Licensure Processing Guide
The Pennsylvania Department of State this announced a brand new public facing Licensure Processing Guide. The guide breaks down the licensing process into three phases and provides the average length of time each phase will take as of the previous quarter. It also offers recommendations for how to shorten processing times. Additionally, new to the department’s website are two short videos, “How to Apply for a Professional License” and “What Happens to My Application.” The first boards featured in the Licensure Processing Guide are the Cosmetology, Nursing and Osteopathic Medicine Boards. More licensing boards will be built and additional licenses will be added to existing boards on a rolling basis, with the Medical, Real Estate and Engineering Boards in process now.