CMS Takes Tough Stance On Price Transparency Violations
More than 500 hospitals received warnings from the federal government since April for non-compliance on the hospital price transparency regulation. Further notices could be sent soon. Hospitals receive an initial 90-day warning with instructions to correct any deficiencies. A subsequent 45-day deadline is sent requiring a more concrete plan to address deficiencies. If hospitals remain out of compliance, sanctions can run as high as $5,500 per day or over $2 million per year.
Additional article: https://www.modernhealthcare.com/providers/mh-cms-hospital-price-transparency-data/
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#pricetransparency #hospitals #cms
Employers To Shake Up PBM Contracts
A Pharmaceutical Strategies Group survey concludes health plans are thinking about shaking up how they manage pharmacy benefits due to surging costs. Among strategies include different drug pricing arrangements, rejecting single pharmacy benefit models, and embracing third-party vendors. Some are unbundling traditional pharmacy benefits manager services, looking for the best deal among various offerings. They are also looking to enter into their own rebate arrangements.
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#pbms #drugpricing #employercoverage
https://www.modernhealthcare.com/insurance/mh-employer-pbm-models-psg-survey
WISeR Could Be Axed By Congress
A key House panel voted unanimously Tuesday to end a pilot program testing prior authorizations in fee-for-service (FFS) Medicare.
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#medicare #priorauthorization
https://www.modernhealthcare.com/politics-regulation/mh-house-committee-wiser-medicare-pilot
AdventHealth Entering Insurance Game
AdventHealth is experimenting with its own insurance products. It has rolled out a narrow network plan to its own employees in certain states and plans on using it as a blueprint for a product to sell to other employers.
#hospitals #healthplans #employercoverage
Social Security Bankrupt In 10 Years
The Social Security Trust Fund will only be able to pay 100% of its total scheduled benefits until the fourth quarter of 2032 — one quarter earlier than the trustees projected last year. Senior lobby AARP says it is a wake-up call and urges action.
#socialsecurity #entitlements
https://thehill.com/homenews/administration/5916868-aarp-social-security/
— Marc S. Ryan
