June 5, 2024

Nursing Home Staffing Mandate Under Fire

President Biden’s pro-union nursing staffing mandate is now facing bipartisan opposition in Congress. The rule threatens to create a consolidation in the nursing home industry with small, independent firms selling to big chains because they cannot meet or afford standards. A lawsuit also seeks to challenge Biden’s authority to set such staffing requirements.

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#nursinghomes #healthcare


Antitrust Case Against Sutter Will Again Proceed

A U.S. appeals court overturned a 2022 ruling that said Sutter Health did not engage in anticompetitive practices. The case is now reopened due to the fact that the jury did not hear crucial evidence.

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#antitrust #healthcare


Prominent Senator Lays Blame on HHS For Cyberattacks

Senate Finance Chairman Ron Wyden, D-OR, laid blame for the recent Change Healthcare cyberattack on the Department of Health and Human Services (HHS), saying it had a lax regulatory stance on cyber security. He is not wrong. We need stronger regulations, funding, and training on the issue throughout the healthcare system.

Additional article: https://www.modernhealthcare.com/politics-policy/politics-policy/ron-wyden-hhs-healthcare-cybersecurity-change-unitedhealth

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#cyberattacks #healthcare


What Will CMS Do Given Scan Lawsuit Decision?

Good article on what could happen now that a court ruling says the Centers for Medicare and Medicaid Services (CMS) must redo 2024 Star ratings for Scan Health Plan. CMS may have to revisit star ratings for all plans, pay out millions more in bonuses, and redo 2025 benefit and bid submissions. See my blog tomorrow on the topic.

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#medicareadvantage #stars #cms


MLR Rebates Total Almost $12 Billion

The Kaiser Family Foundation (KFF) finds that the minimum medical loss ratio (MLR) rule for individual, at-risk small group, and at-risk large group markets will total almost $12 billion from 2012 through 2024. Estimates for 2024 are about $1.1 billion.

#mlr #exchanges  


— Marc S. Ryan

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