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Hospital groups urge Congress to avoid DSH cuts

Nine hospital groups have written to Congressional leadership urging lawmakers to avoid the roughly $8 billion in cuts to Medicaid disproportionate share hospital payments, which could start as soon as October 1. In the letter, the groups, which include the American Hospital Association, America's Essential Hospitals and the Association of American Medical Colleges, called the

House committee investigating potentially anticompetitive PBM tactics

The House Oversight Committee has launched an investigation into pharmacy benefit managers' tactics that Chairman James Comer (R-KY) said are "harming patient care and increasing costs for consumers." Comer is calling on senior officials at the Office of Personnel Management (OPM), Centers for Medicare and Medicaid Services and the Defense Health Agency (DHA) for documents and

Legislation seeks to preserve soon-to-expire APM bonus

Two U.S. Senators, Sheldon Whitehouse, D-Rhode Island and John Barrasso, R-Wyoming, have introduced bipartisan legislation that seeks to create a two-year extension for a 5% bonus for doctors who participate in alternative payment models. The bonus is slated to go away in 2023, and with limited time left in the current legislative session, the bill seeks to stave that off.

Lawmakers push CMS to prevent fraud, abuse in ACO REACH model

U.S. Senator Elizabeth Warren (D-Mass.) and Representative Pramila Jayapal (D-Wash.) are spearheading an effort by lawmakers to compel the Centers for Medicare and Medicaid Services to look at the ACO REACH model, with an eye toward preventing program participation in 2023 for organizations with a history of fraud. According to CMS, the ACO REACH model will replace the Global

House members urge changes to No Surprises Act final rule

Leaders of the House Ways and Means Committee have sent a letter to several federal agencies saying the final rule implementing the No Surprises Act favors insurers and should be changed to reflect provider concerns. The law, which bans surprise medical bills, sees payers and providers entering into a third-party arbitration process to settle disputes regarding out-of-network

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