iqtsupport, Author at DeBrunner & Associates

CMS to Congress: You’re the Impediment to Greater Use of Telehealth

The primary obstacle to Medicare making greater use of telehealth is current laws, the Centers for Medicare & Medicaid Services has told Congress in a new report. The report, mandated by the 21st Century Cures Act, outlines the extent of telehealth utilization today, describes its benefits, and suggests potential new and expanded uses for telehelath, but it also notes that Current restrictions on eligible telehealth originating sites appear to be the greatest barrier to preventing the expansion of Medicare telehealth services. The two most significant Medicare restrictions are: 1) requiring the originating site to be located in certain types of [...]

iqtsupport2018-11-20T06:00:23-05:00November 20, 2018|Medicare, Telehealth|

Medicare Advantage to Address Social Determinants of Health

Beginning next year, the Centers for Medicare & Medicaid Services will authorize Medicare Advantage plans to pay for some health-related but non-medical benefits for their members – benefits that will help address social determinants of health that affect the health status of many Medicare beneficiaries. As explained by Health and Human Services Secretary Alex Azar at a recent event in Salt Lake City, These interventions can keep seniors out of the hospital, which we are increasingly realizing is not just a cost saver but actually an important way to protect their health, too. If seniors do end up going to [...]

iqtsupport2018-11-19T06:00:47-05:00November 19, 2018|Medicare|

Medicaid to Help Pay for Food, Heat, Rent?

Maybe. At least that is what Department of Health and Human Services Secretary Alex Azar hinted during a recent symposium held in Salt Lake City. During the event, Azar said that HHS’s Center for Medicare and Medicaid Innovation seeks …solutions for the whole person, including addressing housing, nutrition, and other social needs. Azar hinted at future CMMI action, saying that What if we gave organizations more flexibility so they could pay a beneficiary's rent if they were in unstable housing, or make sure that a diabetic had access to, and could afford, nutritious food? If that sounds like an exciting idea [...]

iqtsupport2018-11-16T06:00:28-05:00November 16, 2018|Center for Medicare and Medicaid Innovation, Medicaid, Medicaid and housing for the disabled|

CMS Proposes New Medicaid Managed Care Regulation

Just two years after a major overhaul of Medicaid managed care regulations, the Centers for Medicare & Medicaid Services is again proposing changes in how the federal government regulates the delivery of managed care services to Medicaid beneficiaries. Under the newly proposed regulation, states would: be free to implement more changes in their managed care programs without seeking federal permission; have slightly more flexibility in how supplemental payments are made to hospitals through managed care plans and implement some such changes without federal approval; be permitted to redefine what constitutes an adequate provider network for managed care plans; and not [...]

iqtsupport2018-11-14T06:00:22-05:00November 14, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations|

The Changing of the Congressional Health Care Guard

Last week’s elections will bring to office in January a new majority party in the House and changes in the Senate as well. Changes in leadership are coming in all of the House committees with jurisdiction over health care matters: Energy and Commerce, Ways and Means, Appropriations, and Oversight and Government Reform. New leadership may be coming to the Senate Finance Committee as well. Kaiser Health News has published a look at the relevant committees, their likely new leaders, and the priorities of those new leaders. Find that report here.

iqtsupport2018-11-13T06:00:56-05:00November 13, 2018|Uncategorized|

Election Brings Good News for Medicaid

Medicaid came out on top in elections throughout the country last week. With the arrival of a Democratic majority in the House, attempts to repeal the Affordable Care Act, including its Medicaid expansion, appear to have come to an end – at least for now. Voters in three states approved ballot questions to expand their states’ Medicaid programs. And two states elected governors likely to expand their states’ Medicaid programs. Learn more about what the mid-term elections meant to Medicaid and its future in this Washington Post story.

iqtsupport2018-11-12T06:00:13-05:00November 12, 2018|Medicaid|

North Carolina Proposal Could be Precedent-Setting

Under a new proposal by North Carolina’s state treasurer, health care for state employees could be reimbursed based on a percentage of Medicare rates. North Carolina’s State Health Plan insures more than 700,000 state employees and public school teachers, and under the proposal, doctors, hospitals, and other providers that participate in the plan would agree to accept an as-yet unstated percentage of Medicare rates. The state treasurer estimates that this approach would save the State Health Plan $300 million a year and save plan participants another $60 million a year. According to North Carolina Health News, the state’s hospitals are [...]

iqtsupport2018-11-09T06:00:39-05:00November 9, 2018|Uncategorized|

CMS Releases New Home Health Regulation for 2019

A new regulation will bring changes in how Medicare pays for and regulates home health services in 2019. Included in the regulation released last week are: A 2.2 percent increase in home health payments. Creation of remote patient monitoring benefit for home health patients. Creation of a home infusion benefit. Removal of some measures from the home health quality reporting program. Changes in the home health value-based purchasing model. For a complete look at the changes coming to how Medicare will treat home health services in 2019, go here to see a CMS fact sheet on the new regulation and [...]

iqtsupport2018-11-07T06:00:06-05:00November 7, 2018|Medicare regulations, Medicare reimbursement policy|

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 November agenda were: MedPAC’s mandated report on long-term care hospitals patient functional assessment data used in Medicare payment and quality measurement modifying advanced alternative payment model (A-APM) payments modifying the Medicare-dependent hospital program promoting greater Medicare-Medicaid integration in dual-eligible special-needs plans the Medicare Advantage quality bonus program Medicare Advantage encounter data MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. While its recommendations are not binding on either Congress or the [...]

iqtsupport2018-11-06T06:00:50-05:00November 6, 2018|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

New Home Health Reg Brings Changes

A new home health care regulation finalized by the Centers for Medicare & Medicaid Services brings major changes in how Medicare will pay for home health services in the future. In addition to updating Medicare payment rates, the new rule also: introduces a new home health payment system called the Patient-Driven Groupings Model that de-emphasizes the volume of care provided; authorizes Medicare payments for remote patient monitoring; adds a new home infusion therapy benefit; and reduces the amount of quality data home health providers must report. To learn more about the new regulation, which takes effect on January 1, 2019, [...]

iqtsupport2018-11-02T06:00:49-04:00November 2, 2018|Centers for Medicare & Medicaid Services, Medicare regulations, Medicare reimbursement policy|

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