MHA Today | December 30, 2020

Staff Contact: Andrew Wheeler

A federal judge in Maryland granted a temporary restraining order blocking the Most Favored Nation drug pricing rule from taking effect. The rule cuts Medicare Part B payments to hospitals on 50 drugs to the lowest price paid by certain other countries. The court found the Centers for Medicare & Medicaid Services violated the public comment period in promulgating the interim final rule, which was slated to become effective before the end of the notice and comment period. Numerous health care groups believe the rule penalizes providers while failing to hold drug manufacturers accountable for pricing.

Staff Contact: Jane Drummond

The U.S. appellate court for the District of Columbia ruled against the American Hospital Association in its suit to block the price transparency rule. The association previously received an unfavorable ruling from the district court and appealed, also filing for an emergency stay of the rule’s Jan. 1, 2021, effective date. On Dec. 29, the court dismissed the motion for stay and issued an opinion upholding the rule. The rule will take effect Jan. 1. AHA continues to urge the Biden administration to reevaluate the rule and abstain from enforcement.

Staff Contact: Andrew Wheeler

MHA published a comprehensive analysis of the final Medicare Outpatient Prospective Payment System for calendar year 2021. The analysis includes a summary of the final rule, a description of the methods underlying the analysis, and assessments of the financial implications for your hospital and/or health system. The financial implications include effects of the CY 2021 market basket updates, ambulatory payment classification factor updates, wage index adjustments and predetermined market basket reductions as outlined by the Affordable Care Act.

This analysis, which is available online for authorized users of HIDI Analytic Advantage®, includes a summary for the nation, Missouri and individual hospitals. Nationally, hospitals will experience an estimated 2.44% increase in payments. Missouri hospital payments are projected to increase by an estimated 1.97%. Even though the effects of the Medicare sequestration are not factored into the projected payment increases for 2021, the overall estimated sequestration cuts are footnoted.

Staff Contact: Stephen Njenga

The Agency for Healthcare Research and Quality released its 2019 National Healthcare Quality and Disparities Report. The annual report measures and tracks trends in quality and disparities in terms of patient safety, person-centered care, care coordination, effective treatment, healthy living, care affordability and access to health care. It also provides a comprehensive overview of the quality of health care received by the general population and disparities in care experienced by different racial, ethnic and socioeconomic groups.