Proposed 340B rebate model generates an array of concerns among providers
Hospital advocates are pushing back on a fast-approaching rebate model for the 340B Drug Pricing Program, while a new Congressional Budget Office (CBO) report illustrates the accelerating spending in the program. The Health Resources and Services Administration (HRSA), which administers 340B, previously announced that a pilot program to test the application of a rebate model…
The hospital tax exemption comes under scrutiny in Congress
At a time when concerns over reimbursement and costs already are intensifying, Congress recently held a hearing to discuss policy changes that could exert further pressure on the not-for-profit (NFP) hospital sector. A subcommittee of the House Ways and Means Committee met Sept. 16 to examine the NFP hospital tax exemption, soliciting proposals that could…
CMS describes how $50 billion will be distributed for rural healthcare
The Trump administration announced the application period for the Rural Health Transformation Program, giving states an opportunity to claim a piece of a $10 billion FY26 allotment on behalf of their hospitals and clinics. Created by the budget reconciliation bill known as the One Big Beautiful Bill Act, the fund is set to disburse up…
A large health system says revenue could fall by at least $50 million if the ACA subsidies expire
With time running short to maintain enhanced subsidies for the Affordable Care Act (ACA) insurance marketplaces, health system leaders are trying to gauge the consequences of a potential mass disenrollment. Universal Health Services (UHS), a for-profit system that operates more than 400 care sites, is one of the few healthcare organizations to have publicly released…
CMS gives updates on upcoming Medicaid state-directed payment limits
CMS has issued guidance to Medicaid programs about implementing required restrictions on the state-directed payments (SDPs) made through Medicaid managed care organizations (MCOs). The budget reconciliation law known as the One Big Beautiful Bill Act (OBBBA) includes a provision that all SDPs submitted after July 4 for hospitals must be limited to the Medicare rate…
Senate, House release diverging HHS budget proposals for FY26 (updated-2)
Note: This article was updated Sept. 16 with news about a short-term continuing funding resolution and Sept. 10 with new numbers for some provisions in the House appropriations bill. Sept. 16 update Republicans in the House are focusing on a short-term continuation of FY25 federal funding as the most direct route to avoiding a partial…
Report by HFMA and Eliciting Insights examines hospitals’ journey to realize the potential of AI
Although healthcare AI technology has been in the pipeline for years, new feedback suggests implementation remains a work in progress at hospitals and health systems. As described in an HFMA report produced with Eliciting Insights, most organizations are still striving to develop an AI strategy and install an AI governance structure. Findings of the report…
Court limits CMS’s authority to immediately apply the ACA marketplace program integrity final rule
A federal judge blocked many of the Trump administration’s plans to constrict enrollment in Affordable Care Act (ACA) marketplace health plans in the name of program integrity. In an Aug. 22 ruling, Judge Brendan Hurson (a Biden appointee) of the U.S. District Court for Maryland issued a stay of key provisions of a CMS final…
Q2 Honor Roll: HFMA certifications were awarded to 3,446 members
HFMA offers 11 certifications for members to validate their expertise and demonstrate their commitment to the profession. The certifications are as follows: Certified Healthcare Financial Professional (CHFP), Certified Revenue Cycle Representative (CRCR), Certified Revenue Cycle Representative (CRCR) – GCC, Certified Specialist Accounting and Finance (CSAF), Certified Specialist Business Intelligence (CSBI), Certified Specialist Physician Practice Management…
Healthcare fraud enforcement ramps up in the Trump administration, with implications for all stakeholders
Even as hospital leaders consider how to manage decreased reimbursement and higher costs, federal fraud enforcement continues to have some of the most significant financial stakes of any healthcare industry issue. Rather than taking a hands-off approach, the Trump administration is maintaining and even expanding the Biden administration’s push in this area. Two months ago,…