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The article mentions U.S. President Donald Trump administration's release of a final rule on increasing drug cost transparency on Medicare Part D, but without the proposed passing of price concessions negotiated by the pharmacy to patients as of May 20, 2019.

The article reports that the U.S. Centers for Medicare and Medicaid Services (CMS) closed out the comment period in May 2019 on a request for information seeking ideas on how it could eliminate barriers on insurers' ability to sell cross-border plans. Topics discussed include view of industry groups on retooling the regulatory framework, main challenges that states face in operationalizing cross-border individual market insurance sales, and concerns of providers and some state regulators.

The article reports that the American Hospital Association (AHA) is lobbying to urge the U.S. Department of Justice to stop health insurer Cantene Corporation's acquisition of Wellcare Health Plans. AHA claimed that the merger will reduce competition in Medicaid managed-care and Medicare Advantage plans. Cantene' chief executive officer (CEO) Michael Neirdorff acknowledged that there are states where insurers have three plans each but assured that there will be divestitures.

The article reports on the support given by the National Rural Health Association on the increase made in the wage index of rural health workers and the negative reactions of urban hospital workers on the increase.

The article discusses the proposal by the U.S. Centers for Medicare and Medicaid Services(CMS) to boost payment for the new but expensive chimeric antigen receptor T-cell cancer therapy (CAR-T) to ensure patients' access to treatment.

The article mentions the call of flexibility by U.S. hospitals and cancer centers on the Centers for Medicare and Medicaid Services (CMS) in covering costly and evolving cancer treatment after its proposed national determination for chimeric antigen receptor T-cell therapy as of April 22, 2019.

The article mentions the likely movement of Medicare beneficiaries from a physician-led to a hospital-led accountable care organization (ACO) as they develop more complex diseases which would burden hospital ACOs with higher costs as of April 22, 2019.

The article reports on the U.S. Centers for Medicare and Medicaid Services' (CMS) 2.3% pay increase proposal for inpatient rehabilitation facilities as of April 22, 2019.

The article reports on the recommendation of the Medicaid and CHIP Payment Advisory Commission (MACPAC) that the U.S. Congress change the definition of a Medicaid shortfall following hospitals' challenge of the calculation in court. Topics discussed include MACPAC's proposal for the exclusion of the costs and payments for Medicaid patients and the impact of terms in the shortfall on the amount of disproportionate-share hospital (DSH) payments.

The article reports on the recommendation by the U.S. Medicare Payment Advisory Commission for the Health and Human Services (HHS) to create a national guideline for coding all emergency department visits by 2022.

The article reports that there is a 16% drop in the number of healthcare providers participating in the Bundled Payments for Care Improvement (BPCI) Advanced model introduced by the U.S. Centers for Medicare and Medicaid Services as of March 25, 2019. Topics discussed include the process on how participants receive additional payment; number of participants of the BPCI Advanced model in October 2018; and implications of the withdrawal option to stakeholders.

The article discusses the actions taken by Indian tribe leaders in relation to work requirements for tribal members provided with Medicaid benefits under the rule of the U.S. Centers for Medicare and Medicaid Services.

The article reports on the impacts of the fiscal 2020 budget proposal of the administration of United States President Donald Trump on the U.S. Department of Health and Human Services (HHS) and Medicaid. Topics discussed include imposition of copayments for non-emergency use of emergency departments, Medicaid's disproportionate-share hospital adjustment payments, and reductions in the Affordable Care Act spending for Medicaid expansion.

The article discusses the U.S. Medicare Payment Advisory Commission's revisiting of national coding guidelines for coding emergency department visits and making recommendations by 2020 due to coding problems under the Outpatient Prospective Payment System as of March 11, 2019.

The article reports on U.S. Department of Health and Human Services' use of disclosure and transparency to try to force change. Topics discussed include proposed rules issued by the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health Information Technology to spur interoperability and counter information-blocking and a provision to post a list online of healthcare clinicians and hospitals that block the transfer of patient information.

The article reports that the U.S. Centers for Medicare & Medicaid Services (CMS) has proposed increasing the baseline Medicare Advantage payment rates for 2020 by 1.59 percent. The CMS outlined changed to the program to address the opioid crisis. The rate confirmation is said to be the second part of the 2020 Medicare Advantage Advance Notice. The CMS plans to increase the amount of encounter data to determine risk scores for health plans.

The article reports that the Medicaid and CHIP Payment and Access Commission (MACPAC) wants U.S. Congress to slow down reductions in payments to disproportionate-share hospitals (DSH). MACPAC suggested cutting funding by 2 billion U.S. dollars in October 2019. Easing the DSH cuts gives time for hospitals and states to mitigate the impact of the funding decrease. MACPAC suggested the U.S. Department of Health & Human Services to form a methodology to spread out the cuts.