iqtsupport, Author at DeBrunner & Associates

MACPAC Looks at Medicaid State Directed Payments

In 2016, the Centers for Medicare & Medicaid Services authorized states to direct Medicaid managed care organizations to pay providers according to specific rates or methods. Typically, states use these arrangements, often referred to as state directed payments, to establish minimum payments for certain types of providers or to require participation in value-based payment arrangements. A few states, though, use state directed payments to require Medicaid managed care organizations to make large, additional payments to providers similar to supplemental payments their Medicaid fee-for-service programs. In a new issue brief, the Medicaid and CHIP Payment and Access Commission describes the history [...]

iqtsupport2023-07-05T13:34:25-04:00July 5, 2023|Centers for Medicare & Medicaid Services, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care|

Federal Health Policy Update for June 29

The following is the latest health policy news from the federal government for June 23-29. Some of the language used below is taken directly from government documents. The White House President Biden has issued an executive order on strengthening access to affordable contraception and family planning services for women with private health insurance and through Medicaid, Medicare, and federally supported health programs and to foster research on access. Learn more from this White House fact sheet and the administration’s executive order. Department of Health and Human Services HHS’s Office of the Inspector General (OIG) has posted its final rule [...]

iqtsupport2023-06-29T15:36:39-04:00June 29, 2023|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare reimbursement policy|

MedPAC Urges Congress to Embrace Site-Neutral Medicare Outpatient Payments

Medicare should pay for outpatient care on a site-neutral basis, MedPAC has told Congress in its annual recommendations. Proponents of such a change – including the Medicare Payment Advisory Commission – argue that Medicare should not pay more for services than it needs to and can, if it believes hospital-associated facilities deserve more money, find better ways to provide such additional resources. They also believe such a policy encourages the acquisition of independent medical practices by operators that then increase the price of the same services and that site-neutral payments would help preserve such independent practices while also driving down [...]

iqtsupport2023-06-26T06:00:56-04:00June 26, 2023|Medicare, Medicare reimbursement policy, MedPAC|

MACPAC Proposes New Approach to Helping Safety-Net Hospitals

To improve “…the relationship between total state and federal DSH [Medicaid disproportionate share] funding and the number of non-elderly low-income individuals in a state,” the Medicaid and CHIP Payment and Access Commission has urged Congress to direct the Department of Health and Human Services to change how it calculates Medicaid DSH allotments to the states. This year MACPAC devotes a significant portion of its annual report to Congress to payment policy for safety-net hospitals, and in summarizing its proposal it writes that: In order to reduce the wide variation in state disproportionate share hospital (DSH) allotments based on historical spending, [...]

iqtsupport2023-06-26T06:00:13-04:00June 26, 2023|Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

Federal Health Policy Update for June 22

The following is the latest health policy news from the federal government for June 9-22. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced new flexibilities to help keep Americans insured as states resume Medicaid and Children’s Health Insurance Program (CHIP) renewals. The new flexibilities were announced in a letter sent by HHS Secretary Xavier Becerra to the nation’s governors urging them to adopt all available flexibilities to minimize avoidable coverage losses among children and families. The new flexibilities include permitting managed care plans to assist people currently [...]

iqtsupport2023-06-22T16:04:30-04:00June 22, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, Telehealth|

Health Policy Update for June 8

The following is the latest health policy news from the federal government for May 28 – June 8. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced a new primary care model – the Making Care Primary Model – that will be tested by the Center for Medicare and Medicaid Innovation in eight states. The model seeks to improve care for patients by expanding and enhancing care management and care coordination, equipping primary care clinicians with tools to form partnerships with health care specialists, and leveraging community-based connections [...]

iqtsupport2023-06-08T16:41:06-04:00June 8, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, MedPAC|

Beneficiaries Starting to Feel Effects of Medicaid Unwinding

With the end of the COVID-19 public health emergency, states are now undertaking in earnest the challenge of reconsidering Medicaid eligibility for millions of people currently on their Medicaid rolls – something federal law has prohibited them from doing since the early days of the pandemic. And while 65 percent of those currently enrolled in Medicaid, according to a recent survey, are unaware of the current process and the possibility that they may soon lose their Medicaid eligibility, states are already reconsidering beneficiaries’ eligibility. Learn more about what has become known as “Medicaid unwinding” and the impact it is starting [...]

iqtsupport2023-05-30T06:00:52-04:00May 30, 2023|COVID-19, Medicaid|

Federal Health Policy Update for May 25

The following is the latest health policy news from the federal government for May 19-25. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Committee has advanced to the full House two bills with significant implications for health care providers. H.R. 3561 calls for delaying $8 billion a year in Medicaid DSH cuts for two years – cuts scheduled to take effect in October; imposing site-neutral payments for drug infusion services provided in off-campus hospital outpatient departments; imposing stronger price transparency requirements on hospitals; and requiring hospitals to report selected ownership [...]

iqtsupport2023-05-25T15:37:35-04:00May 25, 2023|340b, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations, Telehealth|

Federal Health Policy Update for May 18

The following is the latest health policy news from the federal government for May 12-18. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Health Subcommittee has approved and advanced five bipartisan health care bills. H.R. 3281 combined a number of proposals into a larger package and includes provisions that would: delay for two years Medicaid disproportionate share (Medicaid DSH) cuts currently scheduled to take effect on October 1; require health providers to use a unique identifier for each off-campus or remote outpatient department beginning in 2026; change how Medicare pays [...]

iqtsupport2023-05-18T17:13:49-04:00May 18, 2023|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for May 11

The following is the latest health policy news from the federal government for May 5-11. Some of the language used below is taken directly from government documents. End of the COVID-19 Public Health Emergency DeBrunner & Associates has prepared a summary of the status of selected government health care waivers and flexibilities following expiration of the COVID-19 public health emergency today. The DeBrunner summary covers telehealth, COVID-19 treatment and coverage, flexible hospital operations, long-term-care hospitals, inpatient rehabilitation facilities and units, patient cost-sharing, and state Medicaid waivers. Find the summary here. CMS has sent a memo to state Medicaid and CHIP [...]

iqtsupport2023-05-11T14:13:44-04:00May 11, 2023|340b, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicare, Medicare reimbursement policy, Telehealth|

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