MHA Today | March 18, 2024

Staff Contact: Andrew Wheeler or Brian Kinkade

AHA released results from a survey to gauge the effect of the recent Change Healthcare cybersecurity breach. According to AHA, 74% of hospitals report direct patient care impact, nearly 40% report delays in processing health plan utilization requirements, 94% report financial impact and 82% report impact on cash flow.

CMS issued guidance outlining processes for an expedited state plan amendment for states to advance fee-for-service payments for providers affected by the Change Healthcare attack. The guidance also highlights the existing authority state agencies have to limit managed care plans’ restrictive prior authorization and network practices.

Staff Contact: Andrew Wheeler

MedPAC released a report to Congress that includes recommendations for FY and CY 2024 Medicare payment rates. MedPAC commented that “given the worsened financial circumstances in 2022, and the approximately $3 billion decline in existing Medicare disproportionate share hospital and uncompensated care payments from 2019 to 2024, the Commission contends that all hospitals – and in particular those serving large shares of low-income Medicare patients – warrant greater support than the Commission recommended last year. Thus, the Commission recommends that the Congress update the 2024 Medicare base rates for general ACHs by the amount reflected in current law plus 1.5%.”

Staff Contact: Brian Kinkade

MACPAC released the 2024 report to Congress. In addition to the required analysis on DSH, the MACPAC report includes an analysis of Medicaid managed care denial and appeal processes and recommendations for improving transparency and state oversight.