CMS unveiled a proposed rule Feb. 9 that would reshape the ACA marketplace for plan year 2027, expanding insurer flexibility on plan design, tightening eligibility verification and re-introducing several program integrity measures that were blocked by a federal court last year. The proposed rule, which will be published in the Federal Register on Feb. 11, is accepting public comments through March 11. Multiple provisions would align marketplace rules with requirements enacted under H.R. 1.
Today, we are at an inflection point: we have already lost so many rural hospitals and risk losing even more. But we are also living in a moment of great advances in technology and innovation that allows us to find new ways to address challenges. Hospitals and health systems must start thinking about their use of the Rural Health Fund, $50 billion in federal funding for a new “rural health transformation program,” that was included in the budget reconciliation bill.
Referring to physicians as “providers” undermines their ethical obligations, clinical integrity, accountability and trust with patients, according to a February policy paper from the American Colleges of Physicians. Medical journal articles have previously critiqued the term “provider,” but the industry’s debate about the word’s usage has not adequately addressed ethical significance, the policy paper said. The paper underlined four ethical implications of the word “provider.”
Employers, pharmacists cheer as Congress finally passes PBM reform
After years of conversation, legislators pushed key reforms to pharmacy benefit managers over the finish line, much to the chagrin of the industry. Under the bipartisan health funding deal, PBMs will be required to pass through all drug rebates, fees and other funds to the payer, and, if they fail to comply, the Centers for Medicare & Medicaid Services (CMS) can impose fines.
Like us on Facebook
Follow us on Twitter
Follow us on LinkedIn