joe, Author at DeBrunner & Associates

CMS Axes 340B Model

Following two defeats in federal court, the Centers for Medicare & Medicaid Services has ended its 2025 attempt to launch its 340B Rebate Model Pilot Program. The program, which would have introduced a new approach to the 340B prescription drug discount program under which a limited number of pharmaceutical companies would pay rebates to 340B-eligible entities after they purchase drugs instead of offering discounts for the purchase of those same drugs, as has been the practice since the 340B program’s launch in 1992. Late last year a federal court ruled against the imminent introduction of the model, doing so largely [...]

joe2026-02-11T08:22:39-05:00February 11, 2026|340b|

Docs Not Always Caring for Medicaid Patients

More than a quarter of all doctors enrolled to serve Medicaid patients in 2021 did not serve any Medicaid patients at all while another ten percent treated fewer than 10 Medicaid patients, according to a new Health Affairs study. Among different types of doctors, primary care physicians and cardiologists were most likely to care for higher numbers of Medicaid patients while Medicaid patients seeking the services of psychiatrists were mostly out of luck. Many of the doctors who care for Medicaid patients, and especially those who do not, cite reimbursement that is lower than – and often much lower than [...]

joe2026-02-05T16:51:38-05:00February 10, 2026|Medicaid|

Non-Profit Hospitals Face Near-Term Challenges

The end of Affordable Care Act enhanced health insurance premiums will pose a financial challenge for many of the nation’s non-profit hospitals. The challenge to hospitals will be greatest in states that did not take advantage of Affordable Care Act Medicaid expansion and those with especially large concentrations of rural hospitals that also lack a robust health care safety net. On safer ground will be hospitals in states that do have strong health care safety nets or that have taken recent steps to attempt to fill the void left by the expired insurance premium subsidies. Learn more about the challenges [...]

joe2026-02-05T15:07:41-05:00February 9, 2026|Affordable Care Act, hospitals, Medicaid|

Federal Health Policy Update for February 5

The following is the latest health policy news from the federal government for January 30 through February 5. Some of the language used below is taken directly from government documents. Congress On Tuesday Congress passed, and the president immediately signed, a package of appropriations bills that, among other government operations, funded the Department of Health and Human Services for the rest of federal FY 2026. Major provisions include: The extension of telehealth flexibilities through the end of 2027. The elimination of $8 billion cuts in Medicaid disproportionate share (Medicaid DSH) allotments to the states for both FY 2026 and FY [...]

Demise of Enhanced Tax Credits Drives Lower ACA Plan Enrollment

The end of enhanced tax credits for Affordable Care Act health plans has led to a five percent decrease in the number of people who enrolled in ACA plans during the open enrollment period that ended on January 15. According to federal data, about 23 million Americans signed up for such plans this year, down 1.1 million from last year – a significant decline, although not as great as predictions that enrollment could fall as much as 30 percent. Because of the loss of the enhanced premiums tax credits, insurance premiums doubled for some applicants, putting them out of the [...]

joe2026-01-29T15:49:01-05:00February 2, 2026|Affordable Care Act, Congress|

Federal Health Policy Update for January 29

The following is the latest health policy news from the federal government for January 23-29. Some of the language used below is taken directly from government documents. Congress The Senate today failed to advance a package of the remaining six FY 2026 appropriations bills, including funding for the Department of Health and Human Services. Democratic senators continue negotiating with the White House on how to proceed with Department of Homeland Security (DHS) funding, including the possibility of separating the DHS bill from the broader appropriations package and making targeted amendments to that measure. The Labor, HHS, Education, and Related Agencies bill, [...]

joe2026-02-02T08:58:43-05:00January 29, 2026|Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, MACPAC, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|

Providers Continue to Dominate Fee Dispute Resolution

Health care providers won the vast majority of the fee disputes adjudicated through the No Surprises Act’s Independent Dispute Resolution process during the first half of 2025. The volume of those disputes submitted to arbitration rose nearly 40 percent over the first half of 2024, to 1.2 million cases, and the victory rate of providers also rose, from 85 percent to 88 percent.Leading the way for providers were private equity-backed parties, with three such companies accounting for 44 percent of the disputes submitted during the first half of 2025 and ten of those companies filing nearly 70 percent of all [...]

joe2026-01-28T13:02:20-05:00January 29, 2026|Uncategorized|

Erosion of Rural Maternity Care Continues

At a rate of more than two a month since the end of 2020, rural hospitals have closed or announced that they will be closing their maternity units – 124 in all by the end of 2026. As a result, today only a little more than 40 percent of rural hospitals – most of them safety-net hospitals – continue to provide maternity services, with fewer than a third of such rural hospitals doing so in 12 states. The hospitals blame a number of factors for this continued erosion, including inadequate private insurance and Medicaid payments and difficulty recruiting the providers [...]

joe2026-01-27T16:25:01-05:00January 28, 2026|hospitals, Medicaid|

Federal Health Policy Update for January 22

The following is the latest health policy news from the federal government for January 16-22. Some of the language used below is taken directly from government documents. Congress The House today passed an Appropriations Committee FY 2026 partial spending proposal that includes a Labor, Health and Human Services, Education, and Related Agencies bill. Policy highlights include: Telehealth. The bill would extend the major Medicare telehealth flexibilities and the waiver of periodic in-person visits for mental health telehealth services through the end of 2027. Medicaid DSH. The bill would cancel the FY 2026 and FY 2027 cuts of $8 billion a year and leave just one year, [...]

joe2026-01-22T17:37:45-05:00January 22, 2026|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|

MedPAC Meets

MedPAC’s commissioners held their latest public meeting on Thursday, January 15 and Friday, January 16. The primary subject of the meeting was discussion of MedPAC’s preliminary recommendations for Medicare rates for 2027. The topics on the meeting’s agenda were: Medicare payments for hospital inpatient and outpatient services Medicare payments for physicians and other health professional services Medicare payments for skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis, and hospice services mandated reports on dual-eligible special-needs plans and the impact of recent changes in the home health prospective payment system status reports on the Medicare [...]

joe2026-01-21T12:01:24-05:00January 21, 2026|Medicare, Medicare reimbursement policy, MedPAC|

joe

About joe