Health Law & Policy

Senate approves end to SGRBy a vote of 92-8, the U.S. Senate last night approved legislation ending the long-reviled formula for determining Medicare reimbursements. The vote came just hours before a 21% reimbursement cut would have gone into effect. The measure, which the U.S. House of Representatives passed three weeks ago, now goes to the president, who is expected to sign it.
Pain points keeping execs of safety net health plans up at nightData, quality, specialty drug costs and social determinants of health are the pain points that are keeping executives at nonprofit safety net health plans up at night.
Study finds earlier diabetes diagnoses in Medicaid expansion statesPeople in states that expanded Medicaid under the Affordable Care Act are far more likely to be newly identified with diabetes than in non-expansion states, according to a study published online in Diabetes Care.

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The best and worst states for ob/gyn practice: a professional liability perspectiveMalpractice payouts aren’t the only factor to look at in determining where to practice in the United States. Ob/gyns should also take into account the status of tort reform and the cost of premiums and taxes in the states they are considering.
Oral arguments in King v. BurwellThe oral arguments in King v. Burwell will determine the viability of a central mechanism of the ACA—tax credit subsidies for economically-eligible citizens.
Payment reform shifts to high gear
Payment reform shifts to high gearAfter several years of uneven progress, the pace of healthcare payment reform shifted into high gear in January when the U.S Department of Health and Human Services (HHS) announced plans to tie 30% of traditional, or fee-for-service, Medicare payments to quality or value alternative payment models by the end of 2016, and 50% by the end of 2018.

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The Medicaid expansion divide
The Medicaid expansion divideAfter the first year of Medicaid expansion under the Affordable Care Act (ACA), some healthcare providers and plans on the front lines are confronting operational—as well as political—challenges.
Exchange plans fail to offer required smoking cessation coverageThe overwhelming majority of state health insurance marketplace plans are not providing required coverage for smoking cessation, according to a new report from the American Lung Association.
High-value care strategies
High-value care strategiesThe push is on for physicians to embrace the concept of high-value care, providing patients with appropriate treatment while avoiding wasteful or unnecessary tests. But high-value care requires physicians to navigate many pitfalls, including lack of time to talk with patients and malpractice pressures.
Avoiding self-referral: Understanding the Stark lawsPhysicians today must understand a myriad of laws and regulations that govern not only how they practice medicine, but also how they bill and refer their patients for services both within and outside their own practice.

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