Trending News Today: Federal Lawsuit Challenges ACA Requirement
Top news of the day from across the health care landscape.
The Centers for Medicare and Medicaid Services released a proposal on Monday that would make antibiotic stewardship programs mandatory for health care facilities to help curb the overuse of antibiotics, or be ejected from Medicare, reported The Wall Street Journal. The proposal comes in the wake of the increasing concern over drug-resistant superbugs. This rule would make the programs mandatory for hospitals to get paid by Medicare.
Evergreen Health filed a lawsuit in the US District Court in Maryland against the federal government to avoid having to pay millions to larger insurers under the Affordable Care Act (ACA). According to The Washington Post, the Centers for Medicare and Medicaid Services (CMS) is requiring the company to pay $22 million to the Blue Cross and Blue Shield affiliate, CareFirst, which is a cost that would account for 26% of Evergreen’s 2015 revenue from premiums. “Risk adjustment was designed to stabilize the health insurance markets in the states but, in fact, CMS’s implementation of the program has done just the opposite,” said Chief Executive of Evergreen Health Peter Beilenson. “If the system isn’t changed in the immediate future, many of the country’s most innovative and most affordable health insurance companies could very well go out of business.”
An agreement between New York’s top state lawmakers and Democratic Governor Andrew Cuomo will expand access to breast cancer screening to help combat the disease, reported The Washington Post. The deal would require hospitals to expand the hours when mammograms are offered, and insurance companies will have to eliminate copays and deductibles for these screenings and tests. The proposal is expected to be officially approved this week. The priority to combat cancer followed Cuomo’s girlfriend, Food Network star Sandra Lee, receiving successful treatment. “When Sandy was diagnosed with breast cancer, she was lucky to have caught it early,” Cuomo said. “But not all women are that lucky, and many are not fortunate enough to have the flexibility in their schedule or the resources to fight this disease head on.”