iqtsupport, Author at DeBrunner & Associates

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The March 2022 meeting began with a follow-up discussion on directed payments in managed care. This presentation reviewed a package of five proposed recommendations related to: improving the transparency of existing directed payment approval documents, rate certifications, and evaluations; collecting new provider-level data on directed payment spending; further clarifying directed payment goals and their relationship to network adequacy requirements; providing guidance for more meaningful, multi-year assessments of directed payments; and improving the coordination of [...]

iqtsupport2022-03-08T10:50:01-05:00March 8, 2022|MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid long-term services and supports, Medicaid managed care, Medicaid regulations, Medicaid upper-payment limit|

Federal Health Policy Update for Wednesday, March 2

The following is the latest health policy news from the federal government as of 3:00 p.m. on Wednesday, March 2. Some of the language used below is taken directly from government documents. Provider Relief Fund The Provider Relief Fund FAQ has been updated with three modified questions that address 1099 forms and procedures involved in returning Provider Relief Fund money to the federal government. Find the three updates, all marked “Modified 2/25/2022,” on pages 6 and 8 of the Provider Relief Fund FAQ. Federal Response to Surprise Billing Regulation Court Decision Last week a federal court decision invalidated a major [...]

iqtsupport2022-03-02T17:41:03-05:00March 2, 2022|Accountable Care Organization, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Hospitals Question Feds’ Plan for Doling Out New GME Slots

Last year Congress created 1000 new Medicare-supported graduate medical education residency slots. This year hospitals are unhappy about how regulators propose assigning those new slots. At issue, according to those who responded to CMS’s proposal for apportioning the slots, is the Centers for Medicare & Medicaid Services’ heavy reliance on assigning those slots to providers in Health Professional Shortage Areas (HPSAs). While the legislation calls for incorporating HPSAs into the distribution methodology, provider interests point out, it did not call for the degree of reliance on HPSAs that regulators propose. Doing so, they insist, is contrary to congressional intent. Learn [...]

iqtsupport2022-03-02T06:00:29-05:00March 2, 2022|hospitals, Medicare|

FEDERAL HEALTH POLICY UPDATE FOR FRIDAY, FEBRUARY 25

The following is the latest health policy news from the federal government as of 2:30 p.m. on Friday, February 25. Some of the language used below is taken directly from government documents. Provider Relief Fund HHS made more than $560 million in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 4100 providers across the country this week. According to HHS, approximately 86 percent of all Phase 4 applications have now been processed and the remaining applications will continue to be processed throughout early 2022. To date, HHS has distributed $11.5 billion of the $17 billion allocated [...]

iqtsupport2022-02-25T16:45:53-05:00February 25, 2022|ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, Medicare DSH, Medicare regulations, MedPAC|

Federal Health Policy Update for Friday, February 18

The following is the latest health policy news from the federal government as of 3:00 p.m. on Friday, February 18. Some of the language used below is taken directly from government documents. White House The White House has posted a transcript of the February 16 press briefing given by its COVID-19 response team and public officials. Go here to see the slides presented during the briefing. Centers for Medicare & Medicaid Services Health Policy Update CMS has issued a request for information (RFI) seeking feedback on topics related to Medicaid and the Children’s Health Insurance Program (CHIP), such as enrolling [...]

iqtsupport2022-02-18T17:15:56-05:00February 18, 2022|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, Medicaid, Medicare, Medicare reimbursement policy, MedPAC|

Administration Pursues New COVID Aid Request

The Biden administration plans to ask Congress for another $30 billion in COVID-19 aid. Its wish list reportedly includes: $4.9 billion for testing $3 billion to pay for care for the uninsured $17.9 billion for vaccines and treatments $3.7 billion to pay for new vaccine development $500 million for Centers for Disease Control and Prevention COVID surveillance and operations The wish list reportedly does not include additional money for the Provider Relief Fund. Learn more about what the administration seeks and what happens next in this Washington Post report.

iqtsupport2022-02-17T06:00:21-05:00February 17, 2022|Congress, COVID-19|

Congress May Tackle Hospital Staffing Challenges

Members of Congress are talking about looking into the staffing challenges hospitals currently face. Those challenges include staff – especially but not exclusively nurses – leaving their jobs, citing burnout or difficult working conditions; staff shortages caused by illnesses, often COVID-related; and the fast-rising costs of temporary or travel nurses needed to replace missing staff and the financial burden that is placing on some hospitals. Some members of Congress are considering acting on these challenges; others want the administration to do so. Learn more about the staffing challenges facing hospitals today and possible public policy tools for addressing those challenges [...]

iqtsupport2022-02-16T06:00:48-05:00February 16, 2022|COVID-19, hospitals|

CMS Will Eliminate Medicaid Premiums

The federal government intends to eliminate the premiums it has permitted some states to charge Medicaid beneficiaries in recent years. While the Centers for Medicare & Medicaid Services originally permitted states to charge Medicaid premiums as an inducement to persuade those states to expand their Medicaid programs, studies have found that the premiums mostly discouraged people from enrolling or reenrolling in Medicaid. CMS will compel Arkansas and Montana to phase out their Medicaid premiums by the end of the year and reportedly intends to impose similar requirements on the six other states that impose such fees. Learn more about Medicaid [...]

iqtsupport2022-02-15T06:00:44-05:00February 15, 2022|Medicaid, Medicaid regulations|

Provider Groups Seek Delay in Surprise Billing Arbitration Rule

Health care provider groups are continuing their push to urge a federal court to suspend the portion of the recently implemented No Surprises Act regulation that governs the arbitration process when providers and payers cannot agree on payments. According to the providers, regulators make a policy argument in defense of their implementation of the 2020 surprise billing law, but they argue that policy is established by Congress, not regulators, and that the approach regulators have introduced is contrary to congressional intent as articulated in the law. Specifically, they maintain that the arbitration process establishes a benchmark rate rather than using [...]

iqtsupport2022-02-14T13:00:12-05:00February 14, 2022|Congress|

Telehealth Utilization Tracks Pandemic Decline

The frequency with which Americans are using telehealth to receive some of their health care, which rose considerably during the first year of the COVID-19 pandemic, has declined since doctors returned to their offices and fear of contagion lessened. Even so, the use of telehealth is far more common than it was before the COVID-19 public health emergency. A new analysis of telehealth utilization produced the following findings: Telehealth outpatient visits have declined since the early months of the pandemic. Even amid the general decline in telehealth visits, they remain higher than they were before the pandemic. The non-elderly are [...]

iqtsupport2022-02-11T17:35:08-05:00February 11, 2022|COVID-19, Telehealth|

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