iqtsupport, Author at DeBrunner & Associates

Federal Health Policy Update for August 3

The following is the latest health policy news from the federal government for July 29-August 3. Some of the language used below is taken directly from government documents. Medicare Payment Regulations CMS has issued a final rule updating Medicare payment policies and rates for inpatient and long-term-care hospital services under its inpatient prospective payment system and long-term care prospective payment system for FY 2024. The final rule increases hospital inpatient rates 3.1 percent and LTCH rates 3.3 percent in FY 2024. Other highlights include a nearly $1 billion cut in Medicare disproportionate share (Medicare DSH) and Medicare DSH uncompensated care [...]

iqtsupport2023-08-03T15:28:05-04:00August 3, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|

Millions Cut From Medicaid, CHIP Rolls

Nearly four million Americans have already had their Medicaid or CHIP eligibility terminated as part of the so-called Medicaid unwinding process, according to data compiled by KFF Health News from state and federal sources. That figure, moreover, accounts for only 38 states and the District of Columbia. According to the KFF Medicaid Enrollment and Unwinding Tracker, At least 3,790,000 Medicaid enrollees have been disenrolled as of July 27, 2023, based on the most current data from 38 states and the District of Columbia. There is wide variation in disenrollment rates across reporting states, ranging from 82% in Texas to 10% [...]

iqtsupport2023-07-31T12:00:53-04:00July 31, 2023|Medicaid|

Federal Health Policy Update for July 28

The following is the latest health policy news from the federal government for July 21 -28. Some of the language used below is taken directly from government documents. Medicare Payment Regulations CMS has published a final rule to update Medicare payment policies and rates under its inpatient rehabilitation facility (IRF) prospective payment system and IRF quality reporting program for FY 2024. The final rule includes a 3.4 percent rate increase and changes in the outlier threshold, the case-mix-group relative weights and average length of stay values, and the wage index. In addition, this rule rebases and revises the IRF market [...]

iqtsupport2023-07-28T14:28:17-04:00July 28, 2023|Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|

Administration Seeks to Improve Access to Mental Health Care

New regulations introduced by the Department of Health and Human Services would require health insurers to improve access to mental health services for their members. The newly proposed regulations seek to strengthen the 2008 Mental Health Parity and Addiction Equity Act by requiring health care payers to analyze their members’ access to mental health services by looking at their medical management processes, the adequacy of their provider networks, and the rates they pay those providers. This, HHS believes, would help ensure that insured individuals’ access to such services is as good as their access to physical health care services. Insurers [...]

iqtsupport2023-07-27T06:00:29-04:00July 27, 2023|health equity|

HHS Review Questions Medicaid Managed Care Plans

Medicaid managed care plans may be shortchanging their members on care – or so suggests a new review by the Department of Health and Human Services’ Office of the Inspector General. According to the OIG, the Medicaid managed care plans it audited in 37 states rejected one out of every eight requests for prior authorization, with more than ten percent of the audited plans denying prior authorization requests more than 25 percent of the time. Such findings, the OIG concluded, “…raise(s) concerns about health equity and access to care for Medicaid managed care enrollees.” To address this problem, the OIG [...]

iqtsupport2023-07-26T06:00:12-04:00July 26, 2023|Centers for Medicare & Medicaid Services, Medicaid, Medicaid managed care|

Some States Struggling With Medicaid Eligibility Redeterminations

As many as 12 states have struggled to comply with federal guidelines for redetermining eligibility of their Medicaid population – enough so that the federal government has had to intervene. The Centers for Medicare & Medicaid Services has reportedly halted Medicaid eligibility redeterminations in six states since April and worked closely with six more after concluding that they were not complying with its guidelines for how to go about redetermining the eligibility of the nearly 94 million Americans who were on the Medicaid rolls when the COVID-19 public health emergency ended. During that emergency, many people became newly eligible for [...]

iqtsupport2023-07-24T06:00:49-04:00July 24, 2023|Centers for Medicare & Medicaid Services, COVID-19, Medicaid|

Federal Health Policy Update for July 20

The following is the latest health policy news from the federal government for March 13-16. Some of the language used below is taken directly from government documents. Congress Senator Bernie Sanders (I-VT), chair of the Senate Health, Education, Labor and Pensions (HELP) Committee, has introduced a bill, the “Primary Care and Health Workforce Expansion Act.” The bill would: Increase funding for community health centers by $65 billion over five years, fund the National Health Service Corps at $8.3 billion over five years, and provide $250 million for HRSA coordination for the Women, Infants, and Children (WIC) program. Add 10,000 graduate [...]

iqtsupport2023-07-20T16:54:58-04:00July 20, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy|

Inadequate Data Hinders Federal Approach to Health Equity

Federal efforts to develop and improve payment models and other programs designed to foster health equity are often hamstrung by poor data: inconsistent data requests from program to program and flawed and incomplete data reporting by those participating in those programs. As a result, federal policymakers often are unable to tell whether programs – both those developed specifically to address health equity and those that are not – are having the desired effect on health equity. The result, according to a new study from the Centers for Medicare & Medicaid Services’ Center for Medicare and Medicaid Innovation, is that 1) [...]

iqtsupport2023-07-19T10:50:34-04:00July 19, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity|

Federal Health Policy Update for July 13

The following is the latest health policy news from the federal government for June 30 – July 13. Some of the language used below is taken directly from government documents. 340B CMS has published a proposed regulation outlining how it plans to reimburse hospitals for reductions in 340B prescription drug payments that it implemented from 2018 to 2022 but that a federal court found to be illegal. The agency calculates that it owes participating 340B providers $9 billion, which it proposes paying to those providers in single lump-sum payments. CMS also proposes offsetting these payments through reductions in future non-drug [...]

iqtsupport2023-07-13T15:50:46-04:00July 13, 2023|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Price Transparency Compliance Rises With Penalties

Raising penalties for failure to comply with federal hospital price transparency requirements is increasing compliance with those requirements. Or so concludes a new JAMA Network report. According to a recently published study that examined nearly 4400 acute-care hospitals, … compliance with the 2021 Centers for Medicare & Medicaid Services Price Transparency Rule increased from 70.4% in 2021 to 87.7% in 2022. Increases in compliance were significantly positively correlated with penalty size, which changed from a flat rate to a function of hospital bed counts. Compliance with the requirement, which took effect at the beginning of 2021, was already generally [...]

iqtsupport2023-07-06T06:00:27-04:00July 6, 2023|hospitals|

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