Finalized CMS Rule Sets Limits On State Provider Taxes Funding Medicaid

Modern Healthcare: CMS Provider Tax Rule Tightens State Medicaid Requirements
States will have to find new ways to pay for Medicaid under a regulation the Centers for Medicare and Medicaid Services issued Thursday. The agency finalized a proposal it made last May to crack down on the provider taxes states assess on hospitals, Medicaid insurers and others to help finance their share of Medicaid spending. The final rule also implements related provisions from the tax law President Donald Trump enacted last July. These taxes generate $24 billion a year for states, according to CMS. (Early, 1/29)

Stat: Tech Firms Offer Discounted Help To States On Medicaid Work Requirements
Ten technology vendors are offering $600 million worth of discounts to states that pick them to help implement Medicaid work requirements, the Trump administration announced Thursday, signaling how lucrative they think the sweeping change could be. (Bannow, 1/29) 

Fierce Healthcare: CMS Wants To Reward Hospitals That Buy American
The Centers for Medicare & Medicaid Services (CMS) is looking at ways it could incentivize hospitals to purchase supplies and medications made in the U.S.—including via a potential new “Secure American Medical Supplies” designation within the Medicare program. The agency this week put out the call for public feedback, inviting stakeholders to weigh in on how such a designation “could facilitate the creation of new, streamlined payment policies to support hospitals in their efforts,” according to an advance notice of proposed rulemaking (ANPRM). (Muoio, 1/30)

More health care industry developments —

Modern Healthcare: Medicare Prior Authorizations Off To A Rocky Start, Providers Say
Less than a month into the program that introduced prior authorizations to fee-for-service Medicare, providers say they are running into the kinds of problems they warned about last year. The Centers for Medicare and Medicaid Services launched the Wasteful and Inappropriate Service Reduction Model, or WISeR, on Jan. 1. Under WISeR, vendors use artificial intelligence, machine learning and other technologies to review prior authorization requests for a limited set of procedures in six states through 2031. The agency touts the initiative as a means to reduce waste, fraud and abuse and predicts it will save $3 billion. (Early, 1/29)

MedPage Today: Blanket Ban On Physician Noncompete Agreements Is Off The Table, FTC Says
Physicians described how restrictive noncompete agreements have hurt their careers and their patients during an online workshop hosted by the Federal Trade Commission (FTC) this week. FTC Chair Andrew Ferguson said the agency plans to address anticompetitive noncompete agreements. At the same time, he made clear that the FTC had no interest in pursuing a blanket ban -- something the Biden administration tried and failed to implement. (Firth, 1/29)

Modern Healthcare: Community Health Systems To Sell 3 Hospitals To Tenor, Exit PA
Pennsylvania has given the go-ahead for Community Health Systems to sell three of its hospitals in a deal marking the company’s exit from the state. The Pennsylvania Department of Health has approved Tenor Health Foundation’s acquisition of Commonwealth Health, a CHS spokesperson said Thursday. The CHS subsidiary comprises Regional Hospital and Moses Taylor Hospital in Scranton and Wilkes-Barre General Hospital, along with clinics. CHS would have no affiliated hospitals in Pennsylvania following the close of the transaction, the spokesperson said. (DeSilva, 1/29)

Modern Healthcare: How Ohio Health, Advocate Are Reducing Hospital Readmissions
Health systems are getting smarter on how they handle post-acute care discharges to keep patients from bouncing back to the hospital. They’re educating clinicians on the most appropriate post-acute setting for patients, adding teams to speed up care transitions and going toe-to-toe with health insurers over referral denials. The added focus on process comes as more providers pivot to value-based care, which rewards them for quality and outcomes. (Eastabrook, 1/29)

Stat: Popular Online Lab Tests May Not Be Covered By HIPAA Protections 
As more Americans sidestep doctors’ offices to order lab tests and genetic screenings online, privacy experts warn that the new trove of sensitive health data could end up in the hands of companies selling certain types of insurance, lenders, employers, or law enforcement. (Ravindranath, 1/30)

KFF Health News: Blurry Line Between Medical And Vision Insurance Leaves Patient With Unexpected Bill
Barbara Tuszynski was concerned about her vision but confident in her insurance coverage when she went to an eye clinic last May. The retiree, 70, was diagnosed with glaucoma in her right eye in 2019. She had a laser procedure to treat it in 2022, and she uses medicated drops in both eyes to prevent more damage. She is supposed to be checked regularly, she said. During the May appointment, Tuszynski’s optometrist examined her eyes and reassured her that the glaucoma had not worsened. (Leys, 1/30)

Also —

The New York Times: Pizza Cutter And A Fork: A Bizarre Bid To Break Mangione Out Of Jail 
A man was arrested on Wednesday evening after he impersonated an F.B.I. agent at a federal jail in Brooklyn while carrying a pizza cutter, saying he had a court order for the release of Luigi Mangione, according to a criminal complaint and people familiar with the episode. The man, Mark Anderson, originally from Mankato, Minn., appeared in federal court in Brooklyn on Thursday and was charged with impersonating an F.B.I. agent. A judge ordered him detained at the Metropolitan Detention Center, the same jail that houses Mr. Mangione, who is charged with murder in the 2024 fatal shooting of a health care executive. (Meko, Nerkar and Bromwich, 1/29)