Stricter Price Transparency
The Trump administration finalized its proposed rule that would make the data files mandated under price transparency regulations more usable. The Centers for Medicare & Medicaid Services said the regulation will improve the standardization, accuracy, and accessibility of the data plans and hospitals submit. It also would hold healthcare entities accountable for submitting incomplete or inaccurate data.
In addition, Federal Trade Commission (FTC) Chairman Andrew Ferguson said his agency will crack down on hospitals that are not providing complete and accurate price data, whether or not they are compliant with CMS’ transparency requirements. The FTC noticed 24 large hospitals and health systems for potential violations of consumer protection laws.
In part, the regulation removes the submission of junk data tied to infrequently applied rates or ghost networks. The administration did not finalize certain proposals that would have made price disclosures even more robust.
Additional articles: https://www.fiercehealthcare.com/regulatory/cms-finalizes-updates-price-transparency-regulations-aim-improve-usability and https://www.modernhealthcare.com/politics-regulation/mh-cms-insurer-price-transparency-rule/ and https://www.healthcaredive.com/news/hhs-health-insurer-price-transparency-overhaul-final-rule/832105/ and https://www.beckershospitalreview.com/finance/ftc-warns-hospitals-against-deceptive-pricing-practices/
#pricetransparency #hospitals #healthplans
20 Million Medicare Beneficiaries To Receive Part B Premium Relief
The Trump administration is sending almost 1 million people enrolled in federal Exchange plans a rebate to deal with high healthcare costs. Now, over 20 million Medicare Part B enrollees will receive $90 checks for Medicare premium relief. This is about one-third of the 70 million in Medicare.
The seldom-used Medicare Improvement Fund will be the source of payments. Checks will either be direct deposited or mailed. Those enrolled in Medicare Advantage do not qualify for a rebate. Nor do individuals receiving premium assistance from Medicaid or wealthier seniors.
Additional articles: https://www.fiercehealthcare.com/regulatory/white-house-dispense-part-b-rebates-more-20m-enrollees and https://www.kff.org/quick-insights/the-trump-administrations-90-payment-to-medicare-beneficiaries-reminiscent-of-a-similar-proposal-six-years-ago-may-not-offset-rising-costs/ and https://thehill.com/policy/healthcare/6129313-who-qualifies-for-the-trump-administrations-90-payments-for-seniors/?tbref=hp
#medicare #trump #cms
https://www.healthcaredive.com/news/trump-medicare-part-b-premium-rebate-pledge/832100/
HCSC Explains MA Reduction Moves
Health Care Service Corp. cut their Medicare Advantage (MA) footprint in half less than two years after buying the book of business from Cigna. But the non-profit Big Blue says the narrowed focus will allow it to achieve sustainable growth over time.
HCSC posted a net loss of $1.9 billion in 2025, after making $659 million the year prior. HCSC says the loss was tied to elevated utilization and higher acuity across all lines of business.
HCSC says it is ahead of most targets it set when it closed the Cigna deal. HCSC will still offer MA plans in 478 counties across 24 states in 2027, down from 948 counties in 30 states and Washington, D.C.in 2026. About 127,000 of the company’s 800,000 current MA members will be impacted. About half of them will be able to enroll in another HCSC plan.
#hcsc #medicareadvantage
— Marc S. Ryan
