Health Reform + Related Health Policy News - May 2013

In This Issue:

- Top News

..HHS Releases Hospital Pricing Data in Transparency Effort; Results Show Significant Variation

..States Divided on Medicaid Expansion

..CMS Issues FY 2014 Proposed Rules for Acute-Care and Long-Term Care Hospitals, Skilled Nursing

..Facilities, Inpatient Rehab Facilities, and Hospice

..Appeal of Ruling on Plan B Contraception

- State News

..Pennsylvania Insurance Department Approves Highmark’s Takeover of West Penn Allegheny Health System

..OIG Calls for Refund of $7.3 Million from New York Medicaid

- Regulatory News

..CMS Delays Implementation of Phase 2 Ordering and Referring Denial Edits

..CMS Revises Interim Guidance for Part B Rebilling

..HHS Issues Guidance on Brokers and Agents in Exchange Marketplaces

- Additional Reading

- Federal Register

- For More Information

- Excerpt from: HHS Releases Hospital Pricing Data in Transparency Effort; Results Show Significant Variation:

On May 8, 2013, in an unprecedented effort to provide transparency to health care consumers, the Department of Health and Human Services (HHS) released hospital pricing data from approximately 3,400 hospitals that receive payment from Medicare for inpatient services. The data, which compares charges for services provided during the 100 most common inpatient stays, reveals that hospital charges for similar services can vary significantly -- even within the same geographic area. For example, a fact sheet from the Centers for Medicare and Medicaid Services (CMS) shows that charges to treat heart failure range from $21,000 to $46,000 within the Denver, Colorado, area. Although Medicare does not actually pay the amount that a hospital charges, this data is likely to reignite the debate over medical costs and hospital pricing methodology.

Please see full Newsletter below for more information.

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