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Navigating Value-based Payment
In the 14 years since passage of the Affordable Care Act (ACA) and 9 years since the passage of the Medicare Access and CHIP Reauthorization Act (MACRA), there have been numerous programs developed by Medicare, states and commercial payers to support the movement to outcomes or value-based reimbursement.
CMS Issues Rate Announcement and Final Rule for CY 2026 Medicare Advantage, Prescription Drug Plans
The Centers for Medicare & Medicaid Services (CMS) earlier this month released its rate announcement and final rule on Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly for contract year (CY) 2026.
Fact Sheet: 340B Drug Pricing Program Contract Pharmacy Arrangements
Section 340B of the Public Health Service Act requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at discounted prices to health care organizations that care for patients in vulnerable communities.
Home Health PPS
The Centers for Medicare & Medicaid Services (CMS) Nov. 1 issued its calendar year (CY) 2025 final rule for the home health (HH) prospective payment system (PPS).
AHA Letter Opposing the Physician Led and Rural Access to Quality Care Act (H.R.2191)
AHA expresses opposition to H.R. 2191, the Physician Led and Rural Access to Quality Care Act.
AHA Statement to House Ways and Means Subcommittee on Health for Hearing March 11, 2025
Post-acute care is provided to patients who have been discharged from an acute-care hospital but still require services such as close medical supervision, nursing care, therapies and other support.
Home Health Prospective Payment System Final Rule for CY 2025
The Centers for Medicare & Medicaid Services (CMS) Nov. 1 issued its calendar year (CY) 2025 final rule for the home health (HH) prospective payment system (PPS).
AHA Comments on Medicare Transaction Facilitator Under Medicare Drug Price Negotiation Program
AHA comments on the Centers for Medicare & Medicaid Services information collection request regarding the Medicare Transaction Facilitator (MTF) under the Medicare drug negotiation program.
Special Bulletin: CMS Releases CY 2025 Home Health PPS Final Rule
The Centers for Medicare & Medicaid Services (CMS) Nov. 1 issued its calendar year (CY) 2025 final rule for the home health (HH) prospective payment system (PPS). This Special Bulletin reviews highlights from this rule. The changes from this rule go into effect Jan. 1, 2025.