Medicaid Cuts and ACA Changes Hit Non-Expansion States Hard
New federal budget law containing Medicaid funding cuts and ACA changes disproportionately impact Medicaid non-expansion states, increasing uninsured numbers and straining rural hospitals.
Court Rules Texas Hospitals Must Exhaust Medicare Appeals Before Suing Over Payment Disputes
The Fifth Circuit Court ruled Texas hospitals must complete Medicare's administrative appeal process before filing lawsuits over payment disputes, reversing a lower court decision on HHS payment restrictions.
CMS to Revise Medicare Hospital Payment Weights Using Market-Based Data for FY2029
CMS plans to change Medicare hospital payment weights methodology using Medicare Advantage data starting FY2029, impacting hospital reimbursement and clinical documentation.
Aetna Medicare Advantage’s New Inpatient Payment Policy: Implications and Regulatory Concerns
Examining Aetna's new inpatient payment policy for Medicare Advantage plans, its conflicts with Medicare's Two-Midnight Rule, and implications for hospital reimbursement and compliance.
Medicare Quality Programs Under Scrutiny: Calls for Supportive Reform
Medicare's pay-for-performance programs face criticism for inefficacy and inequity. Experts advocate shifting to supportive models rewarding incremental improvement and incorporating patient-reported outcomes to enhance quality care.
Aetna's New Medicare Advantage Policy Alters Two-Midnight Rule Payment Approach
Effective November 2025, Aetna changes Medicare Advantage inpatient admission payments under the Two-Midnight Rule, impacting hospital reimbursements and billing practices.