The AHA submitted a statement July 11 for a Senate Special Committee on Aging hearing on health care transparency and lowering health care costs. The AHA highlighted commercial insurer operating methods and prescription drug costs as cost drivers incurred by hospitals and health systems. AHA urged Congress for additional oversight of Medicare Advantage plans to stop tactics that restrict and delay care access and called for regulatory and legislative solutions to improve prior authorization processes. Recent legislative efforts to no longer recognize price estimator tools as a method to meet the shoppable services requirement of the Hospital Price Transparency Rule are also a concern, AHA said. As Congress looks at statutory adjustments to the rule, AHA urged consideration of the changes that the Centers for Medicare & Medicaid Services makes on a regular basis. The most recent changes are related to standardization, new data elements, file accessibility, an accuracy and completeness affirmation and changes to CMS’ monitoring and enforcement processes.

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The Centers for Medicare & Medicaid Services May 28 issued a final rule making changes to the Increasing Organ Transplant Access Model beginning July 1.…
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The House Education and Workforce Committee May 21 unanimously passed the Transparency in Billing Act (H.R. 8684). The bill would require off-campus hospital…
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Approximately 35 million Americans are enrolled in Medicare Advantage plans in 2026, and that number is expected to grow to about 45 million MA enrollees by…
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The Centers for Medicare & Medicaid Services May 13 announced 29 health care organizations have pledged early participation in its electronic prior…
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A majority of physicians say the prior authorization process continues to negatively impact patient outcomes and employee productivity, according to a survey…
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The Medicaid and CHIP Payment and Access Commission approved recommendations it will issue to Congress in its June report on oversight and increased…