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American Hospital Association: Hospitals Can Pay Patients' Health Insurance Premiums

"The federal government has no legal authority to prohibit hospitals from paying their patients' insurance exchange premiums to encourage their enrollment, despite a [CMS] statement implying that it does, according to a sharply worded legal advisory from the American Hospital Association [AHA]. What's more, there is clearly no prohibition against hospital-affiliated charitable foundations, or unrelated charities, paying these premiums on behalf of patients, the AHA said ... The financial assistance may be especially helpful to those would-be enrollees whose federal subsidies aren't enough to make coverage affordable."

Medical Error Cost Calculator Riles American Hospital Association

"An online tool ... which determines the 'hidden surcharge' or costs of a hospital's medical errors, employs a methodology that is 'seriously flawed,' says the American Hospital Association. The Leapfrog Group's new 'Hidden Surcharge Calculator,' a web-based tool, enables employers to add up how much of their health premium dollars go to manage hospital medical errors that harm their employees. The tool determines the costs based on the safety track records of each hospital where their workers received care."

Text of Letter from HHS to American Hospital Association on Third-Party Payment of Qualified Health Plan Premiums (PDF)

"We believe that existing guidance related to third-party payments of premiums and cost sharing made on behalf of Marketplace QHP enrollees by private, not-for-profit foundations is sufficient to put the public on notice that as a general matter, such payments are not prohibited by HHS's rules to the extent they are provided in a manner consistent with the February 7, 2014 FAQ. Therefore, we do not intend to issue additional guidance in this area at this time."

American Hospital Association Comments on Commercial Health Plan Abuses

"Certain health plan practices threaten patient access to care and drive excessive administrative costs and burden in the health care system. While these concerns pre-date COVID-19, the current public health emergency both highlights and demands immediate action to protect patients and providers. Regulators should increase their oversight of health plans and implement a comprehensive simplification agenda, beginning with streamlining prior authorization requirements and processes, as well as monitoring for abusive payment delays and denials. These efforts will go a long way to addressing unnecessary costs in the system and allow for a more rational, navigable health system for patients."

Hospital Groups File Lawsuit Challenging Price Transparency Rule

"The plaintiffs -- the American Hospital Association (AHA), the Association of American Medical Colleges (AAMC), the Children's Hospital Association (CHA), and the Federation of American Hospitals (FAH), along with three individual hospitals -- have asked that a federal judge to impose a preliminary and permanent injunction to prevent the government from enforcing the rule, which is set to take effect January 1, 2021." [American Hospital Assoc. et al. v. Azar, No. 19-3619 (D.D.C. complaint filed Dec. 4, 2019)]

Hospitals Trade Association Says No Link Between Hospital Consolidation and Costs

"A Federation of American Hospitals-commissioned report claims, not surprisingly, that hospital consolidation improves care quality and access and that the critics who claim these 'hospital realignments' drive up healthcare costs are relying on old data that does not consider the sweeping effects of healthcare reform."

Transparency Rule for Hospitals Upheld on Appeal

"The American Hospital Association had sued to stop the initiative from taking effect. But in June, a federal judge in the District of Columbia ruled that the new rules were legal. The hospital trade group appealed ... On [December 29], a panel for the U.S. Circuit Court of Appeals in the District of Columbia unanimously upheld the district court's ruling.... The rule, first proposed in July 2019, could upend the $1 trillion hospital industry by unveiling rates long guarded as trade secrets." [American Hospital Association v. Alex Azar, II, No. 20-5193 (D.C. Cir. Dec. 29, 2020)]

Hospitals Get Ready to Fight CMS in Court Again, This Time Over Transparency

"The American Hospital Association, Association of American Medical Colleges and Children's Hospital Association ... are filing a legal challenge alongside member hospitals. The hospital groups charged that the rule will 'introduce widespread confusion, accelerate anticompetitive behavior among health insurers and stymie innovations in value-based care.' "

AHA Presses for Meeting with Federal Agencies as Scrutiny of Hospital Deals Ramps Up

"The American Hospital Association (AHA) wants to make its case to the Biden administration that hospital mergers are not negatively impacting prices or quality ... The hospital advocacy group wrote a letter Wednesday to the leaders of [HHS, DOJ and the FTC] offering updated industry-funded studies on the impact of mergers. The letter comes more than a month after President Joe Biden signed an executive order calling for the DOJ and the FTC to review merger guidelines for hospitals."

Hospital Ownership Changes and Employers' Decision to Offer Insurance (PDF)

25 pages. Excerpt: This study uses 1995 - 1999 Contingent Workers Supplement and hospital ownership data from the American Hospital Association's Annual Surveys to how the employer sponsored insurance market responds to changes in hospital ownership.