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ACHP in the News: A federal court is allowing a group of states to take part in a legal case about CSR subsidies. ACHP President and CEO Ceci Connolly said the uncertainty around CSR payments is making it difficult for insurers to plan for next year and the market is feeling the impact.
Governors and lawmakers pressure Trump on CSR subsidies
A bipartisan group of governors is urging President Trump to pay CSR subsidies to stabilize the market. The group had previously called on Congress to fund the payments. Congressional leaders are exploring legislation that would authorize the subsidies, and many have encouraged the President to temporarily continue the payments. The Administration is currently conducting an analysis on the impact of halting the subsidies. The White House had planned to announce a final decision this week. The next scheduled CSR payment is August 22.
Administration and governors reshape Medicaid through waivers
Republican governors and the Trump Administration are working together to cut costs in Medicaid. States have requested permission from the Trump administration to implement conservative policies such as tightened eligibility, work requirements, required drug testing and higher premium prices for beneficiaries. Critics allege the changes would harm vulnerable beneficiaries and lead to coverage losses, and experts believe some of the provisions could bring lawsuits.
CMS finalizes rule on uncompensated care
CMS announced in a final rule that it will give a $2.4 billion raise to inpatient hospitals in 2018. The amount is less than the $3.1 billion CMS proposed, but more than the $746 million hospitals received in 2017. CMS is also planning on going ahead with changes to reimbursement for compensated care. The new payment system is based on the amount of uncompensated care a hospital claims on its Medicare cost report instead of the number of Medicaid, dual-eligible and disabled patients served.
Finance Committee will take up health care
The Senate Finance Committee will hold hearings in September on stabilizing the market, according to Chairman Orrin Hatch (R-UT). While the Finance Committee will take up the issue, the Senate HELP Committee is expected to take a central role in drafting any legislation aimed at stabilization. Hatch also noted there will be separate hearings for reauthorizing CHIP, which must be reapproved by September 30.
Secretary Tom Price promises regulatory relief to doctors
HHS Secretary Tom Price is taking a physician-friendly approach to his work at HHS, aiming to roll back regulations he claims make life harder for doctors. Price wants to direct $1 billion in savings from hospital cuts to spending on physicians and has given the American Medical Association committee more power over how much the government pays for certain medical services. He also is delaying regulations that penalize doctors who have not shifted from Medicare’s fee-for-service to quality based payments.
Alaska insurer files for double-digit rate decrease
Premera Blue Cross and Blue Shield plans to reduce rates in Alaska by more than 20 percent next year, according to state filings. Premera, the only insurer operating in the state, attributes the rate cut to a recently implemented state reinsurance program and a decrease in the use of medical services. Alaska regulators still have to approve the rate reduction. If the cuts are approved, it would be the first time rates have dropped in Alaska since the ACA was passed. Alaskans have previously seen rate hikes as high as 40 percent.
Molina exits ACA markets
Molina Healthcare has announced that by the end of the year it will no longer sell plans on the exchanges in Utah and Wisconsin. The company cites costs that lead to hefty losses in the second quarter as the reason for withdrawal. Molina has also said it has been hurt by a lack of support for government programs meant to stabilize the marketplace.
Scientists edit human genome, fix disease-causing mutation
U.S. scientists successfully edited a gene in dozens of human embryos to repair a heart disease-causing mutation. The study, published in the journal Nature, renews ethical concerns about using human genetic engineering to create “designer babies.” Some experts say the discovery means gene editing opportunities for preventing disease are more limited than scientists assumed and it is unlikely current methods would be successful for genome enhancement. While the scientists were able to edit the gene, they were not able to add external DNA.
Mary Brainerd joins Stryker Board
Former CEO of HealthPartners, Mary Brainerd, has joined Stryker’s board of directors. Many executives at non-profit health care companies hold positions on boards of other industry organizations, including current and former executives from Dignity Health, Catholic Health Initiatives and Stanford Health Care.