The collapse of the continuing resolution has seriously threatened an elaborately negotiated health care package that touches virtually every medical industry. Why it matters: After weeks of intense bipartisan and bicameral talks, and months of laying the groundwork, the package’s major reforms, reauthorizations of existing laws and extensions of funding streams could all be scrapped. Driving […]

Hospitals dodged the most substantial efforts in the year-end spending package to reform their industry, but advocates tell Peter the door has at least been cracked opened by a limited measure on outpatient billing. Why it matters: After years of focusing on drug costs, this Congress started to train more attention on hospitals, which constitute a much larger share […]

As 2024 comes to a close, we are looking ahead to the 119th Congress and opportunities for our clients to engage with their federal representatives and other decision makers in Washington, DC. • View House and Senate calendars • Questions? Contact Tony Wyatt: anthony@wscdc.com January Events Congressional Swearing-In Day Friday, January 3rd, 2025 | 9:30 […]

Pay-cut draft recommendation reflects strong industry profit Medicare panel may also urge no hospice pay update for 2026 A congressional advisory panel is considering a recommendation that Congress cut Medicare payments to home health agencies by 7% in 2026.   The proposed draft recommendation, revealed Friday at the Medicare Payment Advisory Commission’s December meeting, reflects […]

Language addressing insurer prior authorizations in Medicare Advantage that was holding up a year-end health care deal is likely to be dropped by negotiators. Why it matters: Insurers’ requirements for their sign-off on some physician-ordered care is a big tension point with patients and providers, and measures to streamline the system have been a focus of […]

Congressional Republicans made Democrats an offer on a major package of year-end health provisions this week, sources say. Why it matters: The large-scale offer shows that momentum remains behind finishing a major health package this year, though a deal is far from certain. Democrats are reviewing the offer. There are typically multiple back-and-forth exchanges in […]

The legislation would limit prices and ban hospital facility fees for dozens of health services deemed safe to get in a doctor’s office. State lawmakers are moving to cap prices for dozens of routine health care services, saving New Yorkers an estimated $1 billion annually. New legislation sponsored by state Sen. Liz Krueger and Assemblymember Chantel […]

Acquisitions in the home care industry are poised to take off in 2025, fueled by lower interest rates and President-elect Donald Trump’s incoming administration. Large home care providers including Addus HomeCare, Aveanna Healthcare and the Pennant Group said during third quarter earnings calls they would aggressively look for deals next year to gain scale and better compete for hospital referrals. […]

Audit finds 70% of sample violated Medicare requirements Hospitals billed for care covered by hospice, HHS OIG says Acute care hospitals received over $190 million in improper Medicare payments for outpatient hospice services, government watchdogs say. An audit report released Monday by the US Department of Health and Human Services Office of Inspector General sampled over $283.7 […]

Sens. Bill Cassidy and Maggie Hassan are set to release a framework for Medicare site-neutral payment reforms as early as Friday. Why it matters: Changes to the way hospitals are paid for outpatient procedures could be on the agenda in a lame duck session, and this framework fleshes out more options. Site-neutral proposals address the way hospitals charge […]