House GOP Releases Budget Blueprint for Savings

Introduction House Republicans released a budget blueprint on February 12th that directs the Energy and Commerce Committee to achieve $880 billion in savings from fiscal years 2025 through 2034. GOP Budget Reconciliation Bill Draft Budget Overview The budget resolution does not provide specific instructions on how the committee should achieve the $880 billion in savings. … Read more

Medicaid Spending in the DOGE Radar

Introduction Mr. Musk’s DOGE team has requested access to CMS systems, which manage over $1 trillion in annual payments, according to documents obtained by the New York Times. This initiative, led by Mr. Musk’s longtime associate Steve Davis, aligns with a broader effort to reduce federal spending by scrutinizing payments and contracts. Hospital and health … Read more

Doc Payment Fix Bill in the Works?

A bipartisan group of House representatives introduced a bill on Friday aimed at addressing and exceeding a pay cut for doctors that took effect at the beginning of this year. The legislation, known as the Medicare Patient Access and Practice Stabilization Act of 2025, seeks to mitigate the financial strain on physicians caused by the … Read more

DOJ Recovers $2.9 Billion in Fraud in 2024

The Department of Justice (DOJ) announced that the agency recovered $2.9 billion in resolutions to federal False Claims Act allegations for 2024 (fiscal year ending September 30).  This is a slight increase from the historic $2.7 billion recovered in fiscal year 2023. Office of Public Affairs | False Claims Act Settlements and Judgments Exceed $2.9B … Read more

CCRCs (Life Plan): Econ Data in Marketing?

In a time of constantly changing markets, grasping economic indicators can give marketers a significant advantage. These indicators are statistical/data measures that provide a look into the economy’s present and future conditions, serving as potent instruments for devising marketing strategies in tune with consumer behavior, purchasing power, and the general state of the market. For … Read more

Doc Payment Fix in the Works?

Here’s an oldie but a goodie for today. The House Ways and Means Committee is reportedly considering a markup of legislation this month that would revamp Medicare’s physician payment system. This move could increase the likelihood of incorporating a “doc fix” into a lame duck legislative package. Historic readers and followers of Reg’s Blog will … Read more

The Debate: Policy that Should be Discussed

Tonight’s presidential debate should be policy focused but likely, won’t be or won’t be with sufficient detail.  There are a ton of policy issues that should be discussed. Healthcare policy, in my opinion, should be very much a topic of open and frank discussion. I know I am a geek when it comes to economic … Read more

Check: Medicare Advantage Coverage Issues

Late last year, CMS proposed a final rule to address the issue of coverage denials or service denials via prior authorization on behalf of Medicare Advantage Plans. Between providers and patients, coverage issues have significantly increased as beneficiary participation has increased (today, about 1 in 2 Medicare beneficiaries is in a Medicare Advantage plan). https://rhislop3.com/2023/11/09/cms-offers-fix-to-medicare-advantage-denials/ … Read more

Eighteen CCRCs Impacted by Fitch Ratings Update

Last week I wrote about Fitch Ratings updates to their non-profit CCRC rating criteria.  The expectation with the changes was that twelve percent of the rated CCRCs could be subject to Under Criteria Observation (UCO). What has occurred as a result of Fitch Ratings Update is that eighteen CCRCs have been impacted, falling under UCO.  … Read more

Fitch Non-Profit CCRC Ratings Update

Fitch Ratings has completed updates to its ratings criteria for not-for-profit continuing care retirement/life plan communities (CCRCs), enhancing the reflection of the risk profile for these rated entities. These changes come after a period of commentary on a draft released earlier this spring. The criteria modifications aim to more accurately represent the distinct risks associated … Read more