Supreme Court Sides With HHS Over Medicare Reimbursement Calculation
Roll Call reports that the 7-2 decision rejects an effort by hospitals for higher pay for serving low-income patients. Other Medicare and Medicaid news is on prior authorizations, Medicaid cuts, and more.
Roll Call:
Supreme Court Decides Medicare Reimbursement Calculation
The Supreme Court sided on Tuesday with the Department of Health and Human Services in a dispute over the rate under Medicare the government pays to hospitals that serve low-income patients. The 7-2 decision rejected an attempt from a group of more than 200 hospitals across 30 states to change the formula the government uses to calculate reimbursement for hospitals that serve a disproportionate share of low-income patients. (Macagnone, 4/29)
Bloomberg:
Medicare Administrator Explores Cutting Red Tape For Health Insurance Approvals
Leaders at the Centers for Medicare and Medicaid Services are exploring proposals to limit health insurers’ use of tactics that can delay medical care, people familiar with the discussions said. The aim of the proposals would be to cut the number of medical procedures subject to “prior authorization,” meaning ones in which doctors have to fill out additional paperwork for ultimate approval. CMS is exploring making policies more uniform across different health insurance plans. (Cohrs Zhang, 4/29)
Bloomberg:
Elevance Curbs Online Medicare Sign-Ups As Expenses Rise
Elevance Health Inc. is halting digital enrollment in most of its Medicare health insurance plans, making it harder for brokers to sign up new members after rival UnitedHealth Group Inc. reported a surprise jump in expenses in those programs. The pullback could curb growth in plans that may be losing money for the company, according to industry analysts. Elevance, the second-largest US health insurer, is removing Medicare Advantage plans for the elderly from online platforms that insurance brokers use to sign up members, according to a statement last week from a national group representing health insurance brokers. (Tozzi and Swetlitz, 4/29)
On Medicaid cuts —
Politico:
House Republicans Raise New Medicaid Proposal To Offset Trump's Megabill
House Republicans discussed a new, controversial proposal to cut federal spending for Medicaid in a closed-door meeting late Monday night, as lawmakers even beyond the moderate bloc are warning GOP leaders they will not swallow another alternative. According to four Republicans who were present for the meeting of GOP members of Energy and Commerce — convened to finalize their panel’s portion of the party’s megabill — lawmakers discussed at length a new version of a plan to place so-called “per capita caps” on Medicaid funding to certain beneficiaries in states that have expanded the program under the Affordable Care Act. (Hill and Leonard, 4/29)
Politico:
Don Bacon Sets $500B Red Line On Medicaid
Rep. Don Bacon, a key GOP moderate, is drawing a red line on Medicaid cuts. The Nebraska Republican has privately told the White House he won’t accept more than $500 billion in reductions to the program, according to two people with direct knowledge of the matter. That could complicate the GOP’s effort to pass a domestic policy bill that is set to include an extension of President Donald Trump’s 2017 tax cuts. (Leonard and Lee Hill, 4/29)
The Hill:
House Republicans Disagree On Medicaid Cuts For Expansion States
A key House committee is pushing forward with trying to advance its portion of President Trump’s legislative agenda next week, even as Republicans disagree over how deeply to cut Medicaid. The House Energy and Commerce Committee is planning a May 7 meeting to finalize and advance its portion of the bill, leaving little time for members to iron out differences. The legislation calls for the committee to find $880 billion in savings over a decade, with most of it expected to come from health programs. (Weixel, 4/29)
