Health Insurance / en Fri, 04 Jul 2025 16:38:34 -0500 Thu, 03 Jul 25 14:59:24 -0500 AHA releases Q2 2025 Health Care Plan Accountability Update /news/headline/2025-07-03-aha-releases-q2-2025-health-care-plan-accountability-update <p>The AHA July 3 released the <a href="/health-plan-accountability-update/2025-06-25-health-plan-accountability-update-june-2025" target="_blank">Health Care Plan Accountability Update</a> for the second quarter of 2025. The update covers the latest developments in Medicare Advantage, legislation and regulation of private health insurers, as well as other resources from the last quarter.</p> Thu, 03 Jul 2025 14:59:24 -0500 Health Insurance HHS announces initiative with insurers to streamline prior authorizations  /news/headline/2025-06-23-hhs-announces-initiative-insurers-streamline-prior-authorizations <p>The Department of Health and Human Services June 23 <a href="https://www.hhs.gov/press-room/kennedy-oz-cms-secure-healthcare-industry-pledge-to-fix-prior-authorization-system.html">announced</a> an initiative coordinated with multiple health insurance companies to streamline prior authorization processes for patients covered by Medicare Advantage, Medicaid managed care plans, Health Insurance Marketplace plans and commercial plans. Under the initiative, electronic prior authorization requests would become standardized by 2027. HHS stated that these reforms complement ongoing regulatory efforts by the Centers for Medicare & Medicaid Services to improve prior authorization, including building upon the Interoperability and Prior Authorization final rule. <br> <br>The plan is expected to make the prior authorization process faster, more efficient and more transparent, the agency said. Participating insurers pledged to expand real-time responses by 2027. HHS said that the insurers would also commit to reducing the volume of medical services subject to prior authorization by 2026, including those for common procedures such as colonoscopies and cataract surgeries. <br><br>During a news conference, HHS Secretary Robert F. Kennedy Jr. said unlike previous attempts by insurers, this initiative would succeed because the number of insurers participating represent 257 million Americans. “The other difference is we have standards this time,” he said. “We have ... deliverables. We have specificity on those deliverables, we have metrics, and we have deadlines, and we have oversight.” <br> <br>Mehmet Oz, M.D., CMS administrator, said that the pledge “is an opportunity for industry to show itself.” Sen. Marshall, R-Kan., said that Congress could pursue codifying at least some portions of the initiative in the future. <br><br>Additionally, participating insurers would honor existing prior authorizations during coverage transitions. <br> </p> Mon, 23 Jun 2025 16:31:45 -0500 Health Insurance CMS adds two new No Surprises Act IDR entities /news/headline/2025-06-13-cms-adds-two-new-no-surprises-act-idr-entities <p>The departments of Health and Human Services, Labor, and the Treasury have certified two more <a href="https://www.cms.gov/nosurprises/help-resolve-payment-disputes/certified-idre-list">independent dispute resolution entities</a>, bringing the total number to 15. IDR arbitrators help make payment determinations in disputes between providers, group health plans and health insurance issuers under the No Surprises Act.  </p> Fri, 13 Jun 2025 14:01:47 -0500 Health Insurance AHA Statement on House Reconciliation Legislation /press-releases/2025-05-21-aha-statement-house-reconciliation-legislation <div class="row"><div class="col-md-2"><p>Contact:</p></div><div class="col-md-10"><p>Colleen Kincaid, <a href="mailto:ckincaid@aha.org?subject=RE: AHA Statement on House Reconciliation Legislation">ckincaid@aha.org</a><br>Colin Milligan, <a href="mailto:cmilligan@aha.org?subject=RE: AHA Statement on House Reconciliation Legislation">cmilligan@aha.org</a></p></div></div><p><strong>Rick Pollack</strong><br><strong>President and CEO</strong><br><strong> Association</strong></p><p>May 21, 2025</p><p>On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the Association (AHA) is sharing our concerns about the One Big Beautiful Bill Act (OBBBA) that is being considered on the House floor this week.</p><p>Our hospitals and health systems have significant concerns regarding the harmful Medicaid and Health Insurance Marketplace provisions currently included in the bill. The sheer magnitude of the level of reductions to the Medicaid program alone will impact all patients, not just Medicaid beneficiaries, in every community across the nation. Hospitals — especially in rural and underserved areas — will be forced to make difficult decisions about whether they will have to reduce services, reduce staff and potentially consider closing their doors. Other impacts could include longer waiting times to receive care, more crowded emergency departments, and hospitals not being able to invest in technology and innovations for clinical care.</p><p>In particular, the Medicaid legislative proposals severely restrict the use of legitimate state funding resources and supplemental payment programs, including provider taxes and state directed payments, under the guise of eliminating waste, fraud and abuse. We reject this notion as these critical, legitimate and well-established Medicaid financing programs are essential to offset decades of chronic underpayments of the cost of care provided to Medicaid patients. These new policies are estimated to decimate federal support for the Medicaid program by more than $700 billion over 10 years and will displace health care coverage for millions of Americans, moving them from insured to uninsured status.</p><p>In addition to jeopardizing access to patient care and services, these abrupt policy changes would upend state government budgets and threaten the viability of the health care system to provide essential services to this population. Since these changes are effective immediately upon enactment of the legislation, states will have little or no time to prepare for the significant financial impact on state budgets.</p><p>Given the substantial reduction in Medicaid payments and cuts to the Health Insurance Marketplaces, including allowing the enhanced premium tax credits to expire, millions will lose health care coverage. Therefore, the AHA urges the House to reject efforts to dismantle these vital programs in the OBBBA and preserve health care access for our nation’s vulnerable and working families.</p><p>###</p> Wed, 21 May 2025 21:21:48 -0500 Health Insurance CMS notifies states it will not approve or match funds for designated state health, investment programs  /news/headline/2025-04-11-cms-notifies-states-it-will-not-approve-or-match-funds-designated-state-health-investment-programs <p>The Centers for Medicare & Medicaid Services April 10 <a href="https://www.cms.gov/newsroom/press-releases/cms-refocuses-its-core-mission-and-preserving-state-federal-medicaid-partnership">announced</a> that it does not intend to approve new or extend existing requests for federal funds to match state expenditures on designated state health and designated state investment programs. CMS said its aim is to end Medicaid spending that is duplicative of other federal funding sources or is not directly tied to health care services. </p> Fri, 11 Apr 2025 14:44:43 -0500 Health Insurance AHA comments on CMS Marketplace Integrity and Affordability proposed rule  /news/headline/2025-04-11-aha-comments-cms-marketplace-integrity-and-affordability-proposed-rule <p>The AHA April 11 <a href="/lettercomment/2025-04-11-aha-comments-cms-marketplace-integrity-and-affordability-rule">commented</a> on the Centers for Medicare & Medicaid Services’ 2025 Marketplace Integrity and Affordability <a href="https://www.federalregister.gov/documents/2025/03/19/2025-04083/patient-protection-and-affordable-care-act-marketplace-integrity-and-affordability">proposed rule</a>. While the AHA expressed appreciation of the agency’s efforts to address concerns of large numbers of low-income individuals being unknowingly enrolled into Health Insurance Marketplace plans by certain brokers, the association expressed worry that some CMS proposals to address the issue could create barriers to care for eligible Marketplace consumers.  <br><br>The AHA said it was concerned with CMS estimates that 750,000 to 2 million consumers could lose their coverage due to the proposals. The association encouraged the agency to pause finalizing many of its proposals to give it and stakeholders additional time to consider the impacts while simultaneously taking action to stop brokers responsible for inappropriate enrollments. </p> Fri, 11 Apr 2025 14:39:33 -0500 Health Insurance Analysis finds Marketplace enrollment more than doubled since 2020 /news/headline/2025-04-03-analysis-finds-marketplace-enrollment-more-doubled-2020 <p>A KFF <a href="https://www.kff.org/policy-watch/enrollment-growth-in-the-aca-marketplaces/">analysis</a> published April 3 found that Health Insurance Marketplace enrollment reached a record-high for a fourth consecutive year and has more than doubled since 2020. Marketplace enrollment totaled 24.3 million for 2025, growing by 12.9 million since 2020, a 113% increase. KFF attributed the growth to the enhanced premium tax credits instituted in 2021 that expire at the end of this year. Nearly all states experienced enrollment growth since 2020, and 20 have doubled their enrollment since then. </p> Thu, 03 Apr 2025 16:06:11 -0500 Health Insurance Health Care Plan Accountability Update - March 25, 2025 /health-care-plan-accountability-update-march-25-2025 <div class="container"><div class="row"><div class="col-md-8"><h2><span>TOP NEWS</span></h2><h3><a class="ck-anchor" id="challenges"><span>AHA report examines how growth of MA heightens challenges for rural hospitals</span></a></h3><p>A new AHA <a href="/guidesreports/growing-impact-medicare-advantage-rural-hospitals-across-america" target="_blank">report</a> highlights how certain practices by Medicare Advantage plans are increasing rural hospitals' vulnerabilities and threatening access to care in rural communities.   </p><p>In the report, the AHA found that rural hospitals are receiving only 90.6% of Traditional Medicare rates on a cost basis from MA plans. The report also found that insurers’ requirements interfere with clinicians’ ability to provide timely and effective care. For example, 81% of rural clinicians report declines due to insurer requirements. Rural MA patients face longer hospital stays as well, spending 9.6% more time in the hospital before transitioning to post-acute care compared to similar Traditional Medicare patients. Administrative burdens have also grown, with nearly 4 in 5 rural clinicians reporting an increase in administrative tasks over the past five years, and 86% saying these demands have negatively impacted patient outcomes.</p><p>“With MA plans accounting for more than half of total Medicare enrollment and growing, it’s more important than ever that the program works for patients and the providers who care for them,” <a href="/press-releases/2025-02-20-new-aha-report-shows-growing-pressure-medicare-advantage-rural-hospitals-ability-care-communities" target="_blank">said</a> AHA President and CEO Rick Pollack. “It is critical for policymakers to address the harmful impact of Medicare Advantage’s low reimbursements and excessive administrative burdens to help ensure rural hospitals can continue to provide care to their patients and communities." </p><h3><a class="ck-anchor" id="agendas"><span>AHA releases 2025 Advocacy and Rural Advocacy agendas</span></a></h3><p>The AHA released its 2025 <a href="/system/files/media/file/2025/01/AHA-2025-Advocacy-Agenda-20250114.pdf">Advocacy Agenda</a>  detailing the association's key priorities for Congress, the Administration, regulatory agencies and courts. AHA also released its 2025 <a href="/rural-advocacy-agenda" target="_blank" title="2025 Rural Advocacy Agenda">Rural Advocacy Agenda</a> which includes the difficulties rural hospitals face due to challenges imposed by commercial and Medicare Advantage plans. </p><h3><a class="ck-anchor" id="payment"><span>CMS finalizes notice of benefit and payment parameters for 2026 </span></a><span> </span></h3><p>The Centers for Medicare & Medicaid Services <a href="https://www.federalregister.gov/documents/2025/01/15/2025-00640/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2026-and" target="_blank">released</a> its standards for the health insurance marketplaces for 2026, including those for the issuers and brokers who assist marketplace enrollees. The final rule enhances CMS' authority to address and curtail misconduct by agents and brokers, such as fraudulent changes to an enrollee's health care coverage. The final rule went into effect Jan. 15.  </p><h3><a class="ck-anchor" id="marketplace"><span>CMS says record 24.2 million enrolled in Marketplace coverage for 2025 </span></a><span> </span></h3><p>The Centers for Medicare & Medicaid Services <a href="https://www.cms.gov/newsroom/press-releases/over-24-million-consumers-selected-affordable-health-coverage-aca-marketplace-2025" target="_blank">announced</a> a record 24.2 million consumers selected health coverage through the Health Insurance Marketplace for the 2025 enrollment period that ended Jan. 15. The total was more than double the number of enrollees from 2021, CMS said. Of this year's total, 3.9 million consumers signed up for the first time. </p><h3><a class="ck-anchor" id="partd"><span>AHA supports policy, technical changes to Medicare Advantage, Part D for 2026</span></a> </h3><p>The AHA voiced <a href="/2025-01-27-aha-comments-cms-medicare-advantage-part-d-proposed-rule-contract-year-2026?utm_source=newsletter&utm_medium=email&utm_campaign=aha-today" target="_blank">support</a> for the Centers for Medicare & Medicaid Services' proposed rule on policy and technical changes to Medicare Advantage and Part D for contract year 2026. The proposal includes strengthened oversight of Medicare Advantage Organizations and provided additional protections to ensure MA beneficiary access to basic benefits. It also includes provisions promoting more timely access to care, strengthening behavioral health provider networks, and reducing the administrative burden of plan requirements on health care providers.  <strong> </strong></p><h2><span>MEDICARE ADVANTAGE NEWS </span></h2><h3><a class="ck-anchor" id="insurers"><span>KFF: MA insurers made nearly 50 million prior authorization determinations in 2023</span></a><span> </span></h3><p>An <a href="https://www.kff.org/medicare/issue-brief/nearly-50-million-prior-authorization-requests-were-sent-to-medicare-advantage-insurers-in-2023/" target="_blank">analysis</a> by KFF released Jan. 28 found that Medicare Advantage insurers made nearly 50 million prior authorization determinations in 2023. The finding reflects continued year-over-year increases from 2022 (42 million) and 2021 (37 million) as more people have enrolled in MA. KFF also found that in 2023 there was an average of nearly two prior authorization determinations per MA enrollee.   </p><p>The analysis found that insurers fully or partially denied 3.2 million prior authorization requests (6.4%) in 2023, a smaller share than 2022 (7.4%). In 2023, 11.7% of denied prior authorization requests were appealed in MA and of those cases, 81.7% were partially or fully overturned </p><h2><span>TELL US YOUR STORY</span></h2><p>We want to hear about your experience with commercial health plans and how inappropriate use of prior authorization, payment delays and other harmful policies are affecting your patients. We welcome submissions in writing or by video or image upload. We will not use any information publicly without your permission.</p><img src="/sites/default/files/inline-images/image_16.png" data-entity-uuid="305ddbc5-61b2-404d-b383-76d70b82b7b2" data-entity-type="file" alt="image" width="759" height="311"><p>Log in to our AHA.org to access the <a href="/healthplanaccountability" target="_blank" title="Health Care Plan Accountability Page">Health Plan Accountability page</a> and scroll to the bottom to submit your story or experience. You may also upload documents, videos or other supporting material.</p></div><div class="col-md-4"><div class="panel module-typeC"><div class="panel-heading"><h3 class="panel-title"><span>In This Issue:</span></h3></div><div class="panel-body"><ol><li><a href="#challenges">AHA report examines how growth of MA heightens challenges for rural hospitals</a></li><li><a href="#agendas">AHA releases 2025 Advocacy and Rural Advocacy agendas</a></li><li><a href="#payment">CMS finalizes notice of benefit and payment parameters for 2026</a></li><li><a href="#marketplace">CMS says record 24.2 million enrolled in Marketplace coverage for 2025</a></li><li><a href="#partd">AHA supports policy, technical changes to Medicare Advantage, Part D for 2026</a></li><li><a href="#insurers">KFF: MA insurers made nearly 50 million prior authorization determinations in 2023</a></li></ol></div></div> <section class="top-level-view js-view-dom-id-60080624ff7f192e98b91385a466e7fd24c107e0d2efe17836fa39084245ca64 resource-block"> <p><img alt="Health Plan Accountability Update logo" data-entity-type="file" data-entity-uuid="582e961a-bd33-4ad7-b90d-7ff22d7aed7e" src="/sites/default/files/inline-images/Health-Plan-Accountability-Update-header-900x400.png" /></p> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/health-plan-accountability-update/2025-06-25-health-plan-accountability-update-june-2025" hreflang="en">Health Plan Accountability Update - June 2025</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-06-25T14:29:59-05:00">Jun 25, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/health-care-plan-accountability-update-march-25-2025" hreflang="en">Health Care Plan Accountability Update - March 25, 2025</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-03-28T10:36:59-05:00">Mar 28, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/health-care-plan-accountability-update-december-2024" hreflang="en">Health Care Plan Accountability Update - December 2024</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-12-16T16:04:56-06:00">Dec 16, 2024</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/health-plan-accountability-update-october-2024" hreflang="en">Health Plan Accountability Update - October 2024</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-10-15T23:47:39-05:00">Oct 15, 2024</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/health-care-plan-accountability-update-march-28-2024-july-1-2024" hreflang="en">Health Care Plan Accountability Update: March 28, 2024 - July 8, 2024</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-07-08T00:46:22-05:00">Jul 8, 2024</time> </span> </div></div> </div> </div> </section> </div> --><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/03/health-plan-accountability-update-3-25-2025.pdf" target="_blank" title="Click here to download the March Health Plan Accountability Update.">Download the PDF.</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/healthplanaccountability" target="_blank" title="Click here to explore all AHA resources on Health Plan Accountability.">Visit Health Plan Accountability</a></div></div></div></div> Fri, 28 Mar 2025 10:36:59 -0500 Health Insurance CMS issues proposed rule changing federal marketplace enrollment and eligibility requirements  /news/headline/2025-03-11-cms-issues-proposed-rule-changing-federal-marketplace-enrollment-and-eligibility-requirements <p>The Centers for Medicare & Medicaid Services March 10 <a href="https://www.cms.gov/files/document/MarketplacePIRule2025.pdf">released</a> new proposed policies for health insurance marketplaces, including the issuers, agents and brokers who assist marketplace enrollees. If finalized, the rule would shorten the open enrollment period for all marketplaces to Nov. 1-Dec. 15 and address issues with brokers fraudulently enrolling individuals without their consent by ending a special enrollment period for low-income individuals. CMS also proposed a change to the premium adjustment percentage that would increase the maximum annual cost sharing limitation. The proposed rule includes updates to the income verification process and pre-enrollment verification process for SEPs, changes to the essential health benefits, and modifications to the redetermination and re-enrollment processes, among other policies. Many of the proposed policies would reinstate policies previously finalized during the prior Trump administration.   <br><br>AHA members will receive a Regulatory Advisory with further details.</p> Tue, 11 Mar 2025 16:01:01 -0500 Health Insurance AHA Amicus Brief Challenges MultiPlan, Inc. Motion to Dismiss Antitrust Litigation /amicus-brief/2025-03-11-aha-amicus-brief-challenges-multiplan-inc-motion-dismiss-antitrust-litigation <div class="container"><div class="row"><div class="col-md-8"><h2>Interest of Amici Curiae</h2><p>The Association (AHA) represents nearly 5,000 hospitals, health care systems, and other health care organizations. Its members are committed to improving the health of the communities that they serve, and to helping ensure that care is available to and affordable for all Americans. The AHA educates its members on health care issues and advocates on their behalf, so that the perspectives of hospitals and health systems, along with the patients they serve, are considered in formulating health policy. One way in which the AHA promotes its members’ interests is by participating as amicus curiae in cases with important and far-ranging consequences.</p><p>The Federation of s (FAH) represents more than 1,000 tax-paying community hospitals and health systems throughout the United States. Its members include teaching, acute, inpatient rehabilitation, behavioral health, and long-term care hospitals. They provide patients and communities in 46 states, the District of Columbia, and the Commonwealth of Puerto Rico with access to high-quality, affordable care, including inpatient, ambulatory, post-acute, emergency, children’s, and cancer services. Through advocacy and policy analysis, the FAH promotes market-based innovation, investments in the health care workforce, and the protection of access to full-service hospitals.</p><p>The AHA’s and FAH’s member hospitals have a significant interest in this case. Commercial insurance reimbursements comprise the majority of many hospitals’ revenue. Moreover, because government programs like Medicare do not cover the costs of providing care, commercial reimbursements can be the difference between losing money, breaking even, or earning a sustainable margin.<a href="#fn1"><sup>1</sup></a> The AHA’s and FAH’s member hospitals thus depend on competition among commercial payors to ensure that commercial reimbursement rates are sufficient to cover hospitals’ costs and preserve access to care throughout the United States.</p><h2>Introduction</h2><p>This lawsuit comes at a crucial time for the health care sector. Since the onset of COVID-19, the prices for key inputs—including labor, prescription drugs, and medical equipment—have grown dramatically. America’s hospitals and health systems have borne the lion’s share of these increased costs. Government reimbursements were inadequate before the pandemic; they have since fallen even further behind. In December 2024, for example, the Medicare Payment Advisory Commission noted in a preliminary presentation to Commissioners that hospital Medicare margins were at an all-time low of <em>negative 12.6%, and were projected to remain at that level in 2025.</em><a href="#fn2"><sup>2</sup></a> These worrisome statistics do not include Medicaid shortfalls, which compound the problem even further. According to AHA analysis, the difference between Medicaid payments and costs in 2023 was <em>$27.5 billion.</em><a href="#fn3"><sup>3</sup></a> And to make matters worse, reimbursements from commercial payors have failed to keep pace with hospitals’ increased costs. The result is dire: more than a third of all U.S. hospitals have negative operating margins, bond defaults are up, and hundreds of rural hospitals are on the brink of collapse.</p><p>The situation is much different for the commercial insurance companies that use MultiPlan’s repricing tool. Commercial payors like UnitedHealthcare are some of the largest companies in the world. They generate hundreds of billions of dollars in revenue each year and earn sizeable profits. In 2020, while hospitals were devastated by the COVID-19 outbreak, insurers banked record profits. Several years later, this economic divergence between providers and payors remains consistent. Hospitals and health systems continue to struggle financially. Insurers do not.</p><p>Against this backdrop, it is imperative that courts hold commercial insurers to the same standards as everyone else. The AHA and FAH respectfully submit this <em>amicus</em> brief to offer a broader perspective on what is really at stake here. If, as Plaintiffs allege, MultiPlan has facilitated collusion among commercial insurers throughout the country, this Court’s intervention will help preserve the viability of many struggling hospitals that cannot survive without competitive reimbursements.</p><p><a href="/system/files/media/file/2025/03/AHA-Amicus-Brief-Challenges-MultiPlan-Inc-Motion-to-Dismiss-Antitrust-Litigation.pdf" target="_blank" title="Click here to download the AHA Amicus Brief Challenges MultiPlan, Inc. Motion to Dismiss Antitrust Litigation PDF."><em><strong>Read the full </strong></em><strong>amicus</strong><em><strong> brief.</strong></em></a></p><hr><ol><li id="fn1"><em>See</em> Am. Hosp. Ass’n, <em>The Financial Stability of America’s Hospitals and Health Systems Is at Risk as the Costs of Caring Continue to Rise,</em> at 1 (Apr. 2023) (hereinafter “2023 Cost of Caring Report”), <em>available at</em> <a href="/system/files/media/file/2023/04/Cost-of-Caring-2023-The-Financial-Stability-of-Americas-Hospitals-and-Health-Systems-Is-at-Risk.pdf">/system/files/media/file/2023/04/Cost-of-Caring-2023-The-Financial-Stability-of-Americas-Hospitals-and-Health-Systems-Is-at-Risk.pdf</a>.</li><li id="fn2">Alison Binkowski et al., Medicare Payment Advisory Commission, <em>Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; and mandated report on rural emergency hospitals,</em> at 13, 15 (Dec. 12, 2024), <em>available at</em> <a href="https://www.medpac.gov/wp-content/uploads/2023/10/Tab-D-Hospital-payment-adequacy-and-REH-mandate-December-2024_SEC-1.pdf" target="_blank">https://www.medpac.gov/wp-content/uploads/2023/10/Tab-D-Hospital-payment-adequacy-and-REH-mandate-December-2024_SEC-1.pdf</a>. For this reason, the Commission recommended in January 2025 that Congress update Medicare payment rates for hospital inpatient and outpatient services by the current law amount plus 1% for 2026 and reiterated its recommendation to distribute an additional $4 billion to safety-net hospitals by transitioning to a Medicare safety-net index policy. <em>See</em> Dave Muoio, <em>MedPAC Votes to Recommend Hospital Pay Increases for 2026,</em> Fierce Healthcare (Jan. 17, 2025), <em>available at</em> <a href="https://www.fiercehealthcare.com/providers/medpac-votes-recommend-hospital-pay-increases-2026" target="_blank">https://www.fiercehealthcare.com/providers/medpac-votes-recommend-hospital-pay-increases-2026</a>.</li><li id="fn3">Am. Hosp. Ass’n, <em>Fact Sheet: Medicaid Hospital Payment Basics</em> (Feb. 2025), <em>available at</em> <a href="g/fact-sheets/2025-02-07-fact-sheet-medicaid-hospital-payment-basics">/fact-sheets/2025-02-07-fact-sheet-medicaid-hospital-payment-basics</a>.</li></ol></div><div class="col-md-4"><p><a href="/system/files/media/file/2025/03/AHA-Amicus-Brief-Challenges-MultiPlan-Inc-Motion-to-Dismiss-Antitrust-Litigation.pdf" target="_blank" title="Click here to download the AHA Amicus Brief Challenges MultiPlan, Inc. Motion to Dismiss Antitrust Litigation PDF."><img src="/sites/default/files/inline-images/Page-1-AHA-Amicus-Brief-Challenges-MultiPlan-Inc-Motion-to-Dismiss-Antitrust-Litigation.png" data-entity-uuid="c03d9b55-d4b9-49a6-9d56-8df7a52aac11" data-entity-type="file" alt="AHA Amicus Brief Challenges MultiPlan, Inc. Motion to Dismiss Antitrust Litigation page 1." width="695" height="900"></a></p></div></div></div> Tue, 11 Mar 2025 14:14:47 -0500 Health Insurance