iqtsupport, Author at DeBrunner & Associates

MedPAC Offers Recommendations on FY 2020 Rates, More

Last week the Medicare Payment Advisory Commission released its annual report to Congress. Included in this report are MedPAC’s Medicare rate recommendations for the coming year. They are: hospital inpatient rates – a two percent increase hospital outpatient rates – a two percent increase physician and other health professional services rates – no update skilled nursing facilities – no 2020 increase home health agencies – a five percent rate reduction inpatient rehabilitation facilities – a five percent rate reduction long-term-care hospital services – a two percent increase hospice services – a two percent rate reduction MedPAC also recommended that the [...]

iqtsupport2019-03-19T06:00:37-04:00March 19, 2019|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, Uncategorized|

“Rejected” Medicaid Reforms May Resurface

Partial Medicaid expansion, desired by some Republican governors but rejected by the Trump administration last year, may not be so rejected after all. At least not according to Seema Verma, administrator of the Centers for Medicare & Medicaid Services, which oversees the federal Medicaid program. In a recent interview, Verma said the administration is reconsidering its rejection of partial Medicaid expansion, an idea she supports and that What I have said to states and to governors [is] “Tell me what you want to do, and it’s my job to help you get to where you want to go.” To emphasize [...]

iqtsupport2019-03-18T06:00:23-04:00March 18, 2019|health care reform, Medicaid|

MedPAC Discusses ED Coding Changes

Members of the Medicare Payment Advisory Commission discussed the possibility of recommending to Congress that it call for national guidelines for how hospitals code emergency department services. The change may be needed, the commissioners suggested at their March meeting, because hospitals have gravitated toward coding for higher intensity services as time passes. Such a change, if implemented, could result in less emergency department revenue for some hospitals. Learn more in the Healthcare Dive article “MedPAC eyes changes to ED coding, Part B drug pricing.”

iqtsupport2019-03-15T06:00:51-04:00March 15, 2019|Medicare, MedPAC|

Sneak Preview of Medicaid Spending Limits?

The imposition of spending limits for individual Medicaid recipients has been discussed in Washington policy circles for years and was offered in the White House’s recent FY 2020 budget proposal. While deliberations on such a proposal have never advanced in a meaningful way, the state of Utah is doing more than talking about such an approach: it has petitioned the Centers for Medicare & Medicaid Services for a Medicaid waiver that would enable it to introduce such a system in its state Medicaid program. Under the state’s proposed Medicaid waiver, Utah asks the federal government to limit its own Medicaid [...]

iqtsupport2019-03-14T13:00:42-04:00March 14, 2019|Medicaid|

Administration Asks if Providers Should Reveal Negotiated Rates

A proposed regulation published by the Centers for Medicare & Medicaid Services asks stakeholders if they believe hospitals, doctors, and other providers should be required to share with their patients the rates they are paid by insurers for services, medical devices, prescription drugs, and more. Such transparency, on one hand, would give consumers a better sense of the cost of the services they receive and how their insurers reimburse providers for those costs. Providers, suppliers, and insurers, on the other hand, might be concerned about the loss of what they have come to regard as confidential, proprietary information. Hospitals are [...]

iqtsupport2019-03-14T06:00:19-04:00March 14, 2019|Medicare regulations|

MedPAC Debates Post-Acute Payments

As the Centers for Medicare & Medicaid Services continues to develop a unified payment system for all post-acute-care providers, Congress’s advisors on Medicare payment policy appear ready to weigh in on an important aspect of such a system: Whether payments should be based on entire episodes of care or individual stays in post-acute-care facilities. And at least for now, the Medicare Payment Advisory Commission is leaning toward recommending that post-acute-care payments be based on individual stays. At their March public meeting, MedPAC commissioners expressed concern that post-acute-care payments based on entire episodes of care might create financial incentives for providers [...]

iqtsupport2019-03-13T14:55:27-04:00March 13, 2019|Medicare post-acute care, MedPAC|

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. MACPAC looked ahead to its June 2019 report to Congress on the initial day of the March 2019 Commission meeting. In the morning, sessions focused on potential recommendations to create a grace period for states to determine coverage policies for outpatient prescription drugs and removing or raising the rebate cap; a uniform definition of therapeutic foster care; and treatment of third-party payment when determining hospitals’ Medicaid shortfall for disproportionate share hospital payments. In the [...]

iqtsupport2019-03-13T06:00:16-04:00March 13, 2019|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s March agenda were: two Medicare payment strategies to improve price competition and value for Part B drugs: reference pricing and binding arbitration options for slowing the growth of Medicare fee-for-service spending for emergency department service. Medicare’s role in the supply of primary care physicians evaluating an episode-based payment system for post-acute care mandated report: changes in post-acute and hospice care following the implementation of the long-term care hospital dual payment rate structure MedPAC is an independent congressional [...]

iqtsupport2019-03-12T06:00:49-04:00March 12, 2019|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, post-acute care|

Feds Seek Input on Selling Health Insurance Across State Lines

Working to achieve an objective of reducing the cost of health insurance by encouraging the sale of health insurance policies across state lines, the Centers for Medicare & Medicaid Services has published a request for information seeking input from stakeholders and the public on how this might best be done. According to a CMS news release, the agency seeks … feedback on how states can take advantage of Section 1333 of the Patient Protection and Affordable Care Act, which provides for the establishment of a regulatory framework that allows two or more states to enter into a Health Care Choice [...]

iqtsupport2019-03-11T06:00:41-04:00March 11, 2019|Affordable Care Act, Centers for Medicare & Medicaid Services|

Surprise Medical Bills Lead Patients to Change Hospitals

Patients who receive surprise medical bills are more likely to change hospitals than those who do not, a new study has found. According to an analysis of behavior by obstetrics patients, …11 percent of mothers experienced a surprise out-of-network bill with their first delivery, and this was associated with an increase of 13 percent in the odds of switching hospitals for the second delivery, compared to mothers who did not experience a surprise bill. The study found that this switching often paid dividends for those who switched: Mothers who switched hospitals after a surprise out-of-network bill reduced their relative risk of receiving [...]

iqtsupport2019-03-08T06:00:41-05:00March 8, 2019|hospitals|

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