The AHA submitted a statement July 11 for a Senate Special Committee on Aging hearing on health care transparency and lowering health care costs. The AHA highlighted commercial insurer operating methods and prescription drug costs as cost drivers incurred by hospitals and health systems. AHA urged Congress for additional oversight of Medicare Advantage plans to stop tactics that restrict and delay care access and called for regulatory and legislative solutions to improve prior authorization processes. Recent legislative efforts to no longer recognize price estimator tools as a method to meet the shoppable services requirement of the Hospital Price Transparency Rule are also a concern, AHA said. As Congress looks at statutory adjustments to the rule, AHA urged consideration of the changes that the Centers for Medicare & Medicaid Services makes on a regular basis. The most recent changes are related to standardization, new data elements, file accessibility, an accuracy and completeness affirmation and changes to CMS’ monitoring and enforcement processes.

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An AHA blog published July 28 highlights new electronic prior authorization requirements that begin Jan. 1, 2027, as a result of the Centers for Medicare…
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The Centers for Medicare & Medicaid Services July 27 released its Contract Year 2025 Part C and Part D Program Audit and Enforcement Report, outlining key…
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As major provisions of the 2024 Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization final rule take effect next year,…
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The AHA provided comments July 21 to the Senate Committee on Health, Education, Labor and Pensions on price transparency, nursing workforce and rural…
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The AHA provided comments to the House Energy and Commerce Committee July 21 on two price transparency bills the full committee…
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Americans experience healthcare affordability in different ways. Often, affordability is first considered in terms of health insurance premiums that fit within…