Current & Emerging Payment Models

The AHA, jointly filed a lawsuit against the Department of Health and Human Services for finalizing a policy to phase-in a reduction in payments for hospital outpatient clinic visit services furnished in off-campus provider-based departments that are grandfathered under Section 603 of the…

The Center for Medicare and Medicaid Innovation today announced several COVID-19-related modifications to current and future CMMI alternative payment models.

The Center for Medicare and Medicaid Innovation (CMMI) today announced several COVID-19 related modifications to current and future CMMI alternative payment models (APMs). The adjustments are captured in a summary table and are related to the models’ financial methodologies, quality reporting…

The Centers for Medicare & Medicaid Services released early stakeholder insights from its Accountable Health Communities Model.

The Centers for Medicare & Medicaid Services issued a final rule that implements the standards governing health insurance issuers and the Health Insurance Marketplaces (or “exchanges”) for 2021.

A federal district court in Washington, D.C., heard oral argument in the AHA’s legal challenge to the Centers for Medicare & Medicaid Services’ final rule mandating that hospitals disclose their privately negotiated charges with commercial health insurers.

The Health Resources and Services Administration hosted webinars for health care providers on the agency’s COVID-19 Uninsured Program Portal. During the webinars, representatives from HRSA and United Health Group, the portal administrator, reviewed the process for submitting claims through the…

AHA supports extending the Comprehensive Care for Joint Replacement model for an additional three years, but only on a voluntary basis, the association told the Centers for Medicare & Medicaid Services in comments submitted.

A federal appeals court heard oral arguments in the government’s appeal of its loss in a legal challenge to the 2019 reduction in site neutral payment brought by the AHA, joined by the Association of American Medical Colleges and several AHA member hospitals.

The Centers for Medicare & Medicaid Services announced additional details about its implementation of reporting exceptions and extensions across is quality reporting and value programs.