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FEDERAL HEALTH POLICY UPDATE FOR OCTOBER 20

The following is the latest health policy news from the federal government for the week of October 14 to October 20.  Some of the language used below is taken directly from government documents. White House President Biden has signed an executive order on lowering prescription drug costs.  The order directs HHS to consider additional actions to further drive down prescription drug costs, encourages it to pursue such actions through its Center for Medicare and Medicaid Innovation (CMMI), and directs HHS to submit a formal report within 90 days outlining any plans to use CMMI’s authority to lower drug costs and [...]

COVID Pandemic: It’s Over? It’s Not?

An average of 400 daily COVID-related deaths. The potential loss of access to telehealth services. The need to redetermine Medicaid eligibility for people who benefited from the loosening of eligibility standards under the 2020 Family First Coronavirus Response Act. The upcoming commercialization of COVID vaccines. A promise to the nation’s governors of 60 days’ advance notice. These are among the reasons the federal government recently extended the declaration of the COVID-19 public health emergency for another 90 days. Becker’s Hospital Review takes a closer look at these and other reasons for the public health emergency’s extension in the article “HHS [...]

2022-10-18T06:00:47-04:00October 18, 2022|COVID-19|

Feds Taking the Long View on Monkeypox

Federal health officials are increasingly looking at monkeypox as a long-term challenge that may periodically create short-term crises. The number of monkeypox cases is not increasing exponentially and appears large confined to limited, defined communities and may eventually spread more like a sexually transmitted disease than a pandemic-style threat.  In addition, as time passes more at-risk individuals are likely to receive vaccines to gain protection against the infection.  Meanwhile, efforts continue to find more effective ways to treat the disease.  Monkeypox has long been common in some countries and its presence in the U.S. suggests that it is likely to [...]

2022-10-17T06:00:49-04:00October 17, 2022|Uncategorized|

FEDERAL HEALTH POLICY UPDATE FOR OCTOBER 13

The following is the latest health policy news from the federal government for the week of October 7 to October 13.  Some of the language used below is taken directly from government documents. Public Health Emergency Declaration HHS Secretary Becerra has renewed the COVID-19 Public Health Emergency declaration.  This renewal does not provide the promised 60-day notice of the PHE’s end, so for now, the current declaration is set expire on January 11, 2023.  We will continue to update you on any changes to the PHE timeline.  You can view the PHE renewal here. White House The White House COVID-19 [...]

How Many Will Lose Medicaid Coverage?

When the COVID-19 public health emergency ends, millions of Americans are expected to lose Medicaid coverage. With the public health emergency winding down, states will be permitted to evaluate recipients’ continued Medicaid eligibility and, in many cases, declare ineligible many who currently are enrolled in the program. But how many people will lose their Medicaid coverage? The National Association of Medicaid Directors summarizes estimates from the Urban Institute, the Kaiser Family Foundation, and the Department of Health and Human Services on how many people will lose their Medicaid coverage in its blog entry “The Unwinding: Making Sense of Statistics.”

2022-10-12T14:34:14-04:00October 12, 2022|Medicaid|

Federal Health Policy Update for October 6

The following is the latest health policy news from the federal government for the week of September 26 to October 6.  Some of the language used below is taken directly from government documents. 340B HHS must immediately end its significant cut in reimbursement for 340B-covered prescription drugs provided on an outpatient basis to eligible patients, a federal court has ruled, writing that “The prospective portion of the 2022 reimbursement rate shall be vacated because it is defective and because vacating this portion of the 2022 OPPS Rule will not cause substantial disruption” and that “HHS should not be allowed to [...]

FEDERAL HEALTH POLICY UPDATE FOR THE WEEK OF SEPTEMBER 19-27

The following is the latest health policy news from the federal government for the week of September 19-27.  Some of the language used below is taken directly from government documents. White House The White House has issued a fact sheet summarizing new actions and funding to address the overdose epidemic and support recovery as part of its September “National Recovery Month.” Awarding $1.5 billion for all states and territories to address addiction and the opioid crisis. Investing more than $104 million to expand substance use treatment and prevention in rural communities. Investing $20.5 million to increase access to recovery supports. [...]

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. Supporting the discussion were the following briefing papers: Background on Medicaid Race and Ethnicity Data Collection and Reporting State Strategies and Stakeholder Engagement for Unwinding the Public Health Emergency Continuous Coverage Requirement Improving Rate Setting and Risk Mitigation in Medicaid Managed Care Principles for Assessing Medicaid Nursing Facility Payments Relative to Costs Countercyclical Disproportionate Share Hospital Policies Medicaid Coverage of Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease Review of Proposed Rule on Core Set Reporting and Congressional Request for [...]

Feds Pursue Next Regs for Surprise Billing Law

In their continuing effort to implement the complex No Surprises Act, the 2020 law that seeks to prevent consumers from receiving surprise medical bills, federal regulators are now turning their attention to how providers and payers should inform insured individuals about the costs they may incur for procedures and purchases. Specifically, the federal agencies with jurisdiction over the law and its implementation – the Department of Health and Human Services, the federal Office of Personnel Management, the Internal Revenue Service, the Department of the Treasury, the Department of Labor, and the Employee Benefits Security Administration – have issued a request [...]

2022-09-22T13:00:58-04:00September 22, 2022|Uncategorized|

Risk Adjustment Has Impact on Medicare Readmissions Program

The use of social risk adjustment has helped reduce differences in the penalties assessed to safety-net hospitals and other hospitals by Medicare’s hospital readmissions reduction program, according to a new study. According to the study published in the journal Health Affairs, Seven studies found that adding social risk factors to the program’s base risk-adjustment model (which adjusts only for age, sex, and comorbidities) reduced differences in risk-adjusted readmissions and penalties between safety-net hospitals and other hospitals. Three studies found that peer grouping, the HRRP’s current approach to social risk adjustment, reduced penalties among safety-net hospitals. Two studies found that differences [...]

2022-09-22T06:00:18-04:00September 22, 2022|Medicare, Medicare reimbursement policy|
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