AHA lobbies Senate to change the ACA repeal bill, and other news briefs

Modern Healthcare

  • The hospital industry's largest lobbying organization met and shared its concerns with House leadership about provisions of the Obamacare replacement bill that could ultimately harm the financial stability of many hospitals when their uncompensated care costs soar. Rick Pollack, CEO of the American Hospital Association, said his group worries the bill will result in millions losing insurance. The bill does not repeal the Affordable Care Act's Medicare disproportionate-share cuts, which complicates matters. The cuts were made under the assumption that additional coverage provided under the ACA would reduce the need for the payments.

  • Blue Cross and Blue Shield affiliates in Alabama and Tennessee were the latest plans to sue the federal government to force payment under the Affordable Care Act's risk-corridor program. The insurers say they are owed about $250 million combined in unpaid risk-corridor payments for 2014 and 2015. The risk-corridor program was created to curb insurers' preliminary losses on the health insurance exchanges. Several other insurers, including Blue Cross and Blue Shield of North Carolina, have also sued to recover payments. They and others allege breach of contract.

  • A federal judge in Florida put on hold an order requiring 53 skilled-nursing facilities to return more than $347 million in false claims to the federal government because it could force a total of 183 facilities to “collapse.” Last month, a federal jury found that four Florida-based facility operators fraudulently billed Medicare and Medicaid by falsifying records on the care patients received. All four operators in the suit and more than 100 other companies have a joint loan of $168 million with MidCap Financial. The judge said the facilities don't have the funds to make the payments and doing so would force them to default on loans, triggering “the collapse of scores of skilled-nursing facilities in 17 states.”
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