From Modern Healthcare

Biden, Trump Clash Over Healthcare Plans in First Debate

September 30, 2020

President Donald Trump and former Vice President Joe Biden clashed over their agendas for healthcare reform as the issue took center stage during the first presidential debate on Tuesday.

Biden used the first question of the night about the impending Senate fight over Trump’s Supreme Court nomination as an opportunity to raise concerns about the future of the Affordable Care Act. He criticized Trump for supporting a lawsuit that could upend the ACA and for not presenting a comprehensive replacement plan if the law is struck down. The Supreme Court hears oral arguments Nov. 10 in a case that could determine the law’s fate.

President Donald Trump and former Vice President Joe Biden clashed over their agendas for healthcare reform as the issue took center stage during the first presidential debate on Tuesday.

Biden used the first question of the night about the impending Senate fight over Trump’s Supreme Court nomination as an opportunity to raise concerns about the future of the Affordable Care Act. He criticized Trump for supporting a lawsuit that could upend the ACA and for not presenting a comprehensive replacement plan if the law is struck down. The Supreme Court hears oral arguments Nov. 10 in a case that could determine the law’s fate.

If the law is struck down, Biden claimed that millions would lose health insurance coverage and people with pre-existing conditions would pay more for health insurance….

Read the full Modern Healthcare article

Five Things We Learned About the Anthem-Cigna Merger Fallout

September 2, 2020

A Delaware judge ruled Monday that neither Anthem nor Cigna can collect any damages in the wake of their failed attempt to merge. The 306-page opinion issued by the Delaware Chancery Court revealed details on why the two insurers decided to merge and how it all fell apart. Here are five things we learned about the failed Anthem-Cigna transaction and the power struggle between their CEOs.

1. Merger talks started in 2012

A Delaware judge ruled Monday that neither Anthem nor Cigna can collect any damages in the wake of their failed attempt to merge. The 306-page opinion issued by the Delaware Chancery Court revealed details on why the two insurers decided to merge and how it all fell apart. Here are five things we learned about the failed Anthem-Cigna transaction and the power struggle between their CEOs.

1. Merger talks started in 2012

Anthem and Cigna first began mulling a transaction in August 2012—three years before a deal was struck, according to the court opinion. Cigna first proposed a merger in which Anthem’s stockholders would own 55% of the new combined organization’s equity. Seats on the new company’s board would be split equally between the companies, and Cigna would lead the organization. Anthem viewed the deal as “opportunistic” and backed out….

Read the full Modern Healthcare article

CMS to Require COVID-19 Test Results for 20% Medicare Add-On Payment

August 26, 2020

Starting next week, CMS is requiring hospitals have positive COVID-19 laboratory tests in patients’ records to qualify for Medicare’s 20% add-on payment.

The new rule, which CMS said seeks to address “potential Medicare program integrity risks,” applies to admissions beginning Sept. 1. Until now, CMS guidance has said a provider’s documentation—but not necessarily a positive test result—is sufficient to receive the 20% higher Medicare reimbursement for inpatient COVID treatment.

Starting next week, CMS is requiring hospitals have positive COVID-19 laboratory tests in patients’ records to qualify for Medicare’s 20% add-on payment.

The new rule, which CMS said seeks to address “potential Medicare program integrity risks,” applies to admissions beginning Sept. 1. Until now, CMS guidance has said a provider’s documentation—but not necessarily a positive test result—is sufficient to receive the 20% higher Medicare reimbursement for inpatient COVID treatment.

CMS will continue to automatically apply the 20% add-on payment for COVID-19 claims after the rule takes effect. The agency will enforce the requirement through post-payment audits, with the extra 20% being recouped if no test results are found….

Read the full Modern Healthcare article

Provider-Relief Grant-Spending Reports Due in February 2021

July 22, 2020

Healthcare providers will be required to account for how they spent COVID-19 relief grants by February 2021, HHS quietly announced on Monday.

When lawmakers established the $175 billion Provider Relief Fund, one of the stipulations was that healthcare providers receiving large grants would have to submit quarterly reports to HHS and to an oversight commission on their spending, starting on July 10. But HHS delayed that reporting deadline last month and said providers wouldn’t have to submit quarterly reports.

Healthcare providers will be required to account for how they spent COVID-19 relief grants by February 2021, HHS quietly announced on Monday.

When lawmakers established the $175 billion Provider Relief Fund, one of the stipulations was that healthcare providers receiving large grants would have to submit quarterly reports to HHS and to an oversight commission on their spending, starting on July 10. But HHS delayed that reporting deadline last month and said providers wouldn’t have to submit quarterly reports.

Instead, healthcare providers that received more than $10,000 from the Provider Relief Fund will have to account for all the grant funds they spent in 2020 by February 15, 2021, according to a new HHS notice document….

Read the full Modern Healthcare article

Trump Signs Second Major COVID-19 Relief Package

March 18, 2020

President Donald Trump has signed Congress’ second major COVID-19 relief package which includes an increase in state Medicaid funding that hospitals liked and a requirement that insurers do not charge cost-sharing for services related to coronavirus testing.

Here’s a rundown of the major provisions of the Families First Coronavirus Response Act relevant to the healthcare industry. The Senate passed the bill 90-8, and President Trump immediately signed it.

President Donald Trump has signed Congress’ second major COVID-19 relief package which includes an increase in state Medicaid funding that hospitals liked and a requirement that insurers do not charge cost-sharing for services related to coronavirus testing.

Here’s a rundown of the major provisions of the Families First Coronavirus Response Act relevant to the healthcare industry. The Senate passed the bill 90-8, and President Trump immediately signed it.

Increase in Medicaid matching funds

The federal government’s Medicaid matching funds will increase across the board by 6.2%. Hospital groups including the Greater New York Hospital Association, Federation of American Hospitals and America’s Essential Hospitals supported the payment bump. Similar policies were enacted in two previous bailout packages in the 2000s….

Read the full Modern Healthcare article