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Iowa Healthcare Law Blog News & Updates on Legal, Policy, & Business Issues Facing the Health Care Industry in Iowa

Category Archives: Healthcare costs

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MACRA’S QUALITY PAYMENT PROGRAM HAS GONE LIVE – ACTION REQUIRED IN 2017 TO AVOID PART B PAYMENT REDUCTIONS IN 2019 – QPP BASICS TO KNOW IN GETTING STARTED

Posted in MACRA - Medicare Access and CHIP Reauthorization Act

MACRA’S QUALITY PAYMENT PROGRAM HAS GONE LIVE – ACTION REQUIRED IN 2017 TO AVOID PART B PAYMENT REDUCTIONS IN 2019 – QPP BASICS TO KNOW IN GETTING STARTED A new Congress has convened, a new administration is at the helm, and repeal of the Affordable Care Act (ACA) is on the docket, an action of… Continue Reading

President-Elect Trump Names Rep. Tom Price, MD (R-GA) as HHS Secretary, Seema Verma, Health Care Consultant, as CMS Administrator

Posted in Affordable Care Act (ACA), American Medical Association, Centers for Medicare and Medicaid Services-CMS, Health and Human Services (HHS), MACRA - Medicare Access and CHIP Reauthorization Act

Medicare/Medicaid Reform and ACA Repeal on the Horizon, MACRA Moves Forward for Now The new administration’s agenda for health care may have come into clearer focus with President-Elect Donald Trump’s nomination of House Representative Tom Price, MD, a Republican from Georgia, as Secretary of Health and Human Services (HHS) and Seema Verma, MPH, as CMS… Continue Reading

CMS publishes Final MACRA Rule for MIPS and APM Incentives

Posted in Centers for Medicare and Medicaid Services-CMS, Electronic Health Records, Health and Human Services (HHS), Healthcare costs, Medicaid

On October 14, 2016, the Centers for Medicare & Medicaid Services (CMS) released its final rule implementing the new Quality Payment Program for physicians in lieu of the repealed sustainable growth rate factor (SGR). Rather than facing substantial annual reductions in Medicare payment fees as a result of the SGR, physicians now have two interrelated… Continue Reading

MACRA ON THE MOVE!

Posted in Centers for Medicare and Medicaid Services-CMS, Electronic Health Records, Healthcare costs, MACRA - Medicare Access and CHIP Reauthorization Act

CMS proposed rule details Medicare’s new physician “Quality Payment Program” Reporting under new measures slated to begin in 2017 The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for Medicare payment to physicians, released a proposed rule on April 27, 2016, setting forth key provisions of its Quality Payment Program for physicians,… Continue Reading

US Supreme Court Upholds ACA Tax Credits for All Qualified Individuals

Posted in Affordable Care Act (ACA), Healthcare costs

US Supreme Court Upholds ACA Tax Credits for All Qualified Individuals Purchasing Health Insurance Through a Marketplace Exchanges In King v. Burwell, the Court’s 6-justice majority concludes that denying ACA tax credits to individuals on federally-facilitated State exchanges is contrary to what Congress intended. King v. Burwell, U.S. Supreme Court No. 14-114, decided June 25,… Continue Reading

SENATE PASSES H.R. 2, IMMEDIATELY REPEALING THE SGR, EXTENDING 1.0 WORK FLOOR GPCI

Posted in Centers for Medicare and Medicaid Services-CMS, Healthcare costs, MACRA - Medicare Access and CHIP Reauthorization Act

The Senate passed H.R. 2, the Medicare Access and CHIP Reauthorization Act (MACRA), on a vote of 92-8. Iowa’s Senators Joni Ernst and Charles Grassley voted in favor of the bill. The Senate considered amendments to the bill as passed by the House, but none were adopted. The H.R. 2 now goes to the President… Continue Reading

Bipartisan House Vote to Repeal SGR – 0.5% Physician Annual Increase

Posted in Centers for Medicare and Medicaid Services-CMS, Healthcare costs, ICD-10

BIPARTISAN HOUSE VOTE TO REPEAL THE SGR – 0.5% PHYSICIAN INCREASE EACH YEAR THROUGH 2019 — EXTENSION OF THE 1.0 WORK GPCI FLOOR THROUGH 2017 – NO ICD-10 DELAY Senate to Vote When It Returns – CMS Issues Payment Advisory The House of Representatives took what the House of Medicine rightfully can call a historic… Continue Reading

BIPARTISAN HOUSE VOTE TO REPEAL THE SGR

Posted in Centers for Medicare and Medicaid Services-CMS, Healthcare costs, ICD-10

.05% PHYSICIAN INCREASE EACH YEAR THROUGH 2019 EXTENSION OF THE 1.0 WORK GPCI FLOOR THROUGH 2017 NO ICD-10 DELAY Senate to Vote When It Returns – CMS Issues Payment Advisory The House of Representatives took what the House of Medicine rightfully can call a historic vote late in the evening of March 26 to really,… Continue Reading

IOWA SUPREME COURT – BLUECARD® AGREEMENTS NOT PRICE FIXING PER SE

Posted in Antitrust & Monopsony in Healthcare, Healthcare costs

MONOPSONY AS A VIABLE THEORY, BUT REQUIRING THE RIGHT FACTS Mueller v. Wellmark, Inc., Iowa Supreme Court No. 13-1872 (filed February 27, 2015) Physicians long have been in tough negotiation positions with large, often dominant commercial health insurers. In its 13th edition report, “Competition in Health Insurance – A Comprehensive Study of U.S. Markets,” the… Continue Reading

HOSPITAL CHARGING STRUCTURE SURVIVES CHALLENGES IN IOWA COURTS

Posted in Healthcare costs

HOSPITAL CHARGING STRUCTURE SURVIVES CHALLENGES IN THE IOWA COURTS Butts et al. v. Iowa Health System and Central Iowa Hospital Corp., Iowa Court of Appeals, No. 13-1034 (filed March 11, 2015) Complaints about hospital and medical costs and bills are legion. This week the Iowa Court of Appeals decided a case challenging hospital billing practices… Continue Reading