Government News of the Week
Medicare Compliance, HIPAA, Medicare Advantage and Part D,
Health Care Reform, and Other Federal and State Government Developments
Government News of the Week is a weekly email newsletter with timely news stories from Washington, D.C., and the 50 state capitals. Articles are selected for their impact on hospitals, health plans, medical group practices, physicians and other health care providers. Subscribe now to get an issue delivered to your inbox every Monday!

September 28, 2015

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(1) Hospitals have a shot at getting back the 0.2% payment reduction that CMS baked into the two-midnight rule when it finalized the 2014 inpatient prospective payment system (IPPS) regulation because of a Sept. 21 federal court decision .... (more)

(2) CMS on Sept. 21 posted the Medicare Advantage (MA) and stand-alone Prescription Drug Plan (PDP) “landscape files” for products offered in the 2016 plan year. .... (more)

  From the AIS Blogs
  The big issue that some MA trade groups have with the results CMS recently outlined of its own new research into the link between serving a highly disadvantaged population and poor plan star ratings seems to be the word "small." Does size matter? Join the conversation at the AIS Blogs.

(3) Democratic presidential candidate Hillary Clinton on Sept. 23 debuted her health care blueprint, one day after lambasting insurance companies for premium increases and pledging a cap on consumers’ drug costs in a campaign speech .... (more)

(4) HHS on Sept. 22 said 17.6 million people have acquired coverage under the Affordable Care Act, and said 10.5 million more are eligible for coverage through the insurance marketplace .... (more)

  From Congress and the Federal Agencies

(5) CMS is “developing implementation plans” for the Notice of Observation Treatment and Implication for Care Eligibility Act (H.R. 876), also known as NOTICE .... (more)

(6) A former employee of Memorial Hermann, who pleaded guilty to mail fraud after his $9 million embezzlement was anonymously reported to the compliance officer, was sentenced to more than seven years in prison .... (more)

(7) A member of Blue Shield of California on Sept. 17 filed a proposed class-action lawsuit against the insurer in U.S. District Court for the Central District of California for allegedly refusing to cover his spinal surgery .... (more)

(8) The Department of Justice (DOJ) said Sept. 18 it has intervened in a whistleblower lawsuit against a critical access hospital in rural Mississippi, a management company and two people who are in ownership or management positions .... (more)


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