joe, Author at DeBrunner & Associates

The New Rural Health Fund

Recognizing that the Medicaid and other health care cuts in the recently enacted FY 2026 budget reconciliation bill – the so-called One Big Beautiful Bill – will exact a heavy toll on rural hospitals, Congress included in that bill a short-term Rural Health Fund designed to help ameliorate the impact of some of the cuts it was adopting. KFF Health has taken a closer look at the Rural Health Fund, how it is structured, and how it is expected to work and has identified some of the bill’s major components. They include: The rural health fund includes $50 billion, which [...]

joe2025-07-23T10:30:29-04:00July 23, 2025|Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid|

OBBB Implementation Timeline

DeBrunner & Associates has prepared a timeline presenting the timeline showing the stages through which the FY 2026 federal budget reconciliation bill (the “One Big Beautiful Bill”) will be implemented. Find it here.

joe2025-07-17T15:53:25-04:00July 21, 2025|Congress, Medicaid, Medicaid regulations, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for July 17

The following is the latest health policy news from the federal government for July 11-17. Some of the language used below is taken directly from government documents. Proposed Medicare Outpatient Prospective Payment and Ambulatory Surgical Center Payment System Regulation for CY 2026 CMS has published its proposed Medicare outpatient prospective payment and ambulatory surgical center payment system rule for CY 2026. Highlights include: A 2.4 percent increase in outpatient rates that is offset by a two percentage point clawback under the 340B final remedy rule, making the actual increase just 0.5 percent. A site-neutral payment policy for the outpatient administration [...]

joe2025-07-17T14:50:40-04:00July 17, 2025|340b, Accountable Care Organization, ACO, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care, social determinants of health, Telehealth|

Hospitals Shedding OB Services

Hospitals are closing down their obstetric services at an alarming rate – especially rural hospitals. According to a recent study: In eight states, more than two-thirds of rural hospitals do not offer OB services. In 2022, the majority of rural hospitals in three states – North Dakota, Oklahoma, and West Virginia – did not offer OB services. More than 40 percent of rural hospitals ended their OB services between 2010 and 2022 in Pennsylvania, South Carolina, West Virginia, and Florida. Between 2010 and 2022, only three states – Delaware, Utah, and Vermont – saw no termination of OB programs. During [...]

joe2025-07-10T15:10:54-04:00July 14, 2025|Uncategorized|

Federal Health Policy Update for July 10

The following is the latest health policy news from the federal government for July 4-10. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has posted an FAQ on inpatient hospital reviews with an emphasis on short hospital stays and its MAC Targeted Probe and Educate (TPE) program. Find that FAQ here. Department of Health and Human Services HHS has rescinded a 1998 interpretation of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) that extended certain federal public health care benefits to illegal residents. Among the health [...]

joe2025-07-10T15:25:22-04:00July 10, 2025|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, MACPAC, Medicaid, Medicare|

States Mull Response to Reconciliation Bill’s Medicaid Cuts

Establishing new grant programs for hospitals, especially for rural hospitals. Reducing or eliminating optional Medicaid benefits such as dental and vision. Cutting payments to providers. Calling their legislature back into session. These are among the moves states are considering in the wake of passage of the FY 2026 budget reconciliation bill that results in hospitals facing a loss of approximately 18 percent of their Medicaid funding over the next decade. Learn more about some the Medicaid financial challenges states now face and how they are considering responding to them in the Stateline article “States scramble to shield hospitals from GOP [...]

joe2025-07-08T11:54:16-04:00July 9, 2025|Medicaid|

Federal Health Policy Update for July 3

The following is the latest health policy news from the federal government for June 27 – July 3. Some of the language used below is taken directly from government documents. Congress/Budget Reconciliation After more than 36 hours of intense lobbying by the administration and House Republican leadership and an all-night legislative session that carried well into Thursday afternoon, the House approved the Senate-passed version of H.R. 1, the reconciliation bill, by a vote of 218-214. Voting was almost entirely along party lines, with all House Democrats voting against it and just two Republicans – Brian Fitzpatrick (PA) and Thomas Massie [...]

joe2025-07-03T16:02:05-04:00July 3, 2025|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

Health Care Implications of Senate Reconciliation Bill

On Tuesday the Senate passed an FY 2026 budget reconciliation bill by a vote of 51-50, with Vice President Vance casting the tie-breaking vote. The bill cuts $1 trillion in Medicaid spending and keeps most of the Medicaid provisions included in the version released by the Senate Finance Committee in mid-June. The bill passed by the Senate creates a fund for rural providers of $50 billion over five years. The major Medicaid provisions in the bill include: A freeze on the size of Medicaid provider taxes, phased down reductions of current taxes toward a new, lower limit for many states, [...]

joe2025-07-02T12:58:19-04:00July 3, 2025|hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare|

CMS Introduces First Prior Authorization Program for Traditional Medicare

Some Medicare-covered services will be subject to prior authorization in some parts of the country under a new model to be launched by the Centers for Medicare & Medicaid Services next year. To run from 2026 through 2031, the “Wasteful and Inappropriate Service Reduction Model,” or WISeR, will test a new process for determining whether enhanced technologies, including artificial intelligence, can expedite prior authorization for selected items and services that have been identified by CMS as particularly vulnerable to fraud, waste, abuse, or inappropriate use. The model will not include inpatient-only services, emergency services, and “…services that would pose a [...]

joe2025-07-01T17:06:55-04:00July 2, 2025|Centers for Medicare & Medicaid Services, CMMI, Medicare, Medicare reimbursement policy|

State Spending on Medicaid Rising – Fast

The states are experiencing almost unprecedented increases in their Medicaid spending – both more money and a larger share of their overall state budgets. According to a new Pew Research Center report, In fiscal year 2023, the combination of expiring federal COVID-19 pandemic aid, slowing tax revenue growth, and rising costs for Medicaid led to an increase in the share of state revenue dedicated to Medicaid of 17.8%, or $44.4 billion, over the previous year – the largest single-year rise in at least two decades. States spent 15.1% of every state-generated dollar on Medicaid, up 2.2 percentage points from the [...]

joe2025-06-26T15:53:22-04:00June 30, 2025|Medicaid|

joe

About joe