Medicare Advantage Payment Delays
Congress Introduces Bipartisan Bill to Combat Medicare Advantage Payment Delays: Lawmakers have introduced legislation requiring Medicare Advantage plans to pay provider claims promptly, with penalties up to $25,000 and interest charges for delays.
Key Takeaway: Healthcare providers faced over $100 million in unpaid claims lasting six months or more in 2022, highlighting the urgent need for standardized payment processes in the growing Medicare Advantage sector.
ACA Subsidy Expiration Impact
Healthcare Providers Face $32B Revenue Loss if ACA Subsidies Expire: A Robert Wood Johnson Foundation analysis warns that U.S. healthcare providers could lose more than $32 billion in revenue next year if enhanced ACA marketplace subsidies expire, with uncompensated care rising by $7.7 billion.
Key Takeaway: The potential expiration of ACA subsidies represents another significant financial pressure point for already-strained hospitals and health systems navigating ongoing federal policy uncertainties.
Government Shutdown Preparations
Hospitals, doctors could lose $32B in revenue next year if ACA subsidies expire: report The White House Office of Management and Budget has instructed federal agencies to consider permanent staff reductions if a government shutdown occurs by October 1, targeting programs that don’t align with Trump Administration priorities.
Key Takeaway: An estimated 20,000 HHS staff could face layoffs, though the full impact on federal healthcare policies and services remains unclear.
State Vaccine Alliances
West Coast and Northeast States Form Health Alliances Amid Federal Vaccine Policy Confusion: Multiple state coalitions have emerged to issue their own vaccine recommendations for COVID, flu, and RSV, going beyond federal ACIP guidelines as states seek to “restore trust” in public health guidance.
Key Takeaway: Growing federal-state disagreements on vaccine policy are fragmenting America’s public health response, creating regional “health care islands” with different recommendations.
On the Horizon Next Week
The specter of a shutdown looms and lack of movement by either the Republicans or Democrats are pushing it to a likely outcome. Democrats have drawn their line in the sand regarding ACA subsidies, we will see who blinks first.