Healthcare, Senior Living, Economics
With both houses of Congress unable to codify some plan to address the evaporating premium supports under the ACA (COVID era addition), President Trump put forth his framework known as The Great Healthcare Plan. For more on the ACA extension/premium supports and related Congressional plans/details, see my earlier post here: https://rhislop3.com/the-aca-subsidies-where-we-are-whats-next/ On January 15, the … Read more
As of January 1, 2026, the scope of Medicare’s site-neutral payment policy expands to include drug administration services—such as chemotherapy and other infused therapies—furnished in excepted (grandfathered) off-campus provider-based departments (PBDs) of hospitals. Under the CY 2026 OPPS final rule published by CMS: CY 2026 OPPS and Ambulatory Surgical Center Final Rule – Hospital Price … Read more
Seven hundred fifty-six rural hospitals in the United States are at risk of closure due to financial instability, with over 40% classified as being at immediate risk. These figures are derived from the Center for Healthcare Quality and Payment Reform’s latest analysis, which utilizes current cost reports submitted to CMS and verified through December 2025. … Read more
Within the last few weeks, I’ve had the opportunity to discuss and review, the ongoing Medicare TPE program with a number of hospices and hospice folks. Suffice to say, there are more than a few questions and resultant (still) confusion over the audit process and claims denial in general. I hope this post provides some … Read more
Last week, I wrote a couple of posts regarding Medicaid, the Affordable Care Act/insurance premium subsidies and the government shutdown. The second of the two posts contained a quick summary of the shutdown impact on Hospital-at-Home programs. https://rhislop3.com/shutdown-is-over-the-pieces/ This post elaborates further on the Hospital-at-Home program, the end of the waiver, the end of the … Read more
The longest government shutdown in United States history concluded on November 12. Yesterday, I wrote a post summarizing the process until resolution – https://rhislop3.com/congress-medicaid-subsidies-whats-next/ Despite the cessation of the shutdown, pivotal issues—most notably the future of enhanced premium tax credits under the Affordable Care Act (ACA), which remain a point of contention for Democratic policymakers—are … Read more
The Centers for Medicare & Medicaid Innovation (Innovation Center), formerly known as CMMI and part of the Centers for Medicare & Medicaid Services (CMS) under the US Department of Health & Human Services (HHS), has released a White Paper (CMS Innovation Center Strategy to Make America Healthy Again | CMS ) outlining a strategic direction … Read more
The U.S. Department of Justice (DOJ) filed a False Claims Act lawsuit on April 4, 2025, against Vohra Wound Physicians Management LLC, Dr. Ameet Vohra, and VHS Holdings, P.A., in the U.S. District Court for the Southern District of Florida (Case No. 25-cv-21570). The complaint alleges that since December 2017, Vohra engaged in a nationwide … Read more
Policy Options and Alternatives to Reduce Medicaid Costs This is part three of a series I wrote on Medicaid spending reductions (proposed). Recent Republican budgets have targeted Medicaid for $800 plus billion in spending reductions. This final post in the series covers the likely choices available from a policy perspective, to achieve the savings target. … Read more
Potential Impacts of Medicaid Cuts on Beneficiaries and Providers This is Part II of a series I researched and produced on Medicaid cuts. The third, which I will edit and post later in the week, will wrap it up. With healthcare spending a major economic issue, I hope these few posts provided context for readers … Read more