joe, Author at DeBrunner & Associates

Medicare, Medicaid Regulations Logjam Should Soon End

The shutdown of the federal government brought the usual flow of Medicare and Medicaid regulations to an almost complete halt. Now that the shutdown has ended, the logjam should end fairly quickly – and with a sense of urgency. Currently, a number of major Medicare and Medicaid regulations remain with the Office of Management and Budget for review. Even though the shutdown has now ended, it is not yet clear when they will be addressed. By statute, the following regulations must be implemented by January 1. CY 2026 Hospital Outpatient Prospective Payment System Policy Changes and Payment Rates and Ambulatory [...]

joe2025-11-13T17:00:30-05:00November 18, 2025|Alternative payment models, Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Health Care and the End of the Shutdown

Passage last week of a continuing resolution to fund the federal government brought the 43-day shutdown to an end – and relief for many health care organizations and the people and communities they serve. The final continuing resolution, which extended federal funding through the end of January of next year, includes: Restoring the delay of reductions of Medicaid disproportionate share hospital (Medicaid DSH) payments. Extending authorization for the Medicare Acute Hospital Care at Home program and Medicare telehealth flexibilities. Extending the low-volume hospital adjustment program and the Medicare-dependent hospital program all through that same date. The bill waives the pay-as-you-go [...]

joe2025-11-13T16:30:32-05:00November 17, 2025|Affordable Care Act, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for November 13

The following is the latest health policy news from the federal government for November 7-13. Some of the language used below is taken directly from government documents. Please note that during the federal government shutdown, most HHS and other health care-related agencies, with limited exceptions, engaged in little public activity such as announcements, the publication of new regulations, and updating their web sites. Now that the shutdown has ended, normal activity can be expected to resume shortly. The End of the Federal Government Shutdown On Wednesday night the House passed the Senate-amended version of the continuing resolution (CR) in a [...]

joe2025-11-13T15:20:05-05:00November 13, 2025|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicare, Medicare reimbursement policy, Telehealth|

Labor and Delivery Situation Worsens at Rural Hospitals

Rural America continues to experience the loss of hospital labor and delivery services. With 2025 not yet over, more rural hospitals – 27 – have closed or are in the process of closing their labor and delivery services than did so in 2024 (21). As a result, only 41 percent of the nearly 2400 rural hospitals in the country today provide labor and delivery services. Of the remaining 900 hospitals still providing these services, 127 of them – 13 percent – are considered to be at risk of closing those services. As a result of this shortage, pregnant women face [...]

joe2025-11-12T12:40:41-05:00November 13, 2025|hospitals|

Applications Highlight Rural Health Targets

Chronic disease prevention. Greater access to mobile health services. Rural clinician recruitment. Improved emergency medical services. Technological advancements. These are among the priorities articulated by rural states in their applications for federal Rural Health Transformation Program funds according to a Stateline analysis of the materials submitted by ten states with large rural populations. All 50 states submitted applications for a piece of the $50 billion pool that was part of the “One Big Beautiful Bill Act” to help offset some of the massive Medicaid cuts that were a major part of that legislation. Applicants for the Rural Transformation Program money [...]

joe2025-11-12T11:42:39-05:00November 12, 2025|Centers for Medicare & Medicaid Services, Medicaid|

Hospitals Dealing With More Self-Pay Patients, Uncompensated Care

Driven by patients’ loss of health insurance, coverage gaps in insurance policies, an increase in high-deductible plans, and the post-COVID changes in Medicaid eligibility, hospitals are encountering growing numbers of uninsured and self-pay patients. In response, they are pursuing ways to improve billing and bill collection while seeking upfront payments from patients with questionable or no coverage, employing patient navigators, and using AI technology. Learn more about the recent increase in self-pay and uninsured patients and how hospitals are responding to this challenge from the Modern Healthcare article “How hospitals are tackling the surge of self-pay patients” (subscription required).

joe2025-11-10T13:13:18-05:00November 11, 2025|hospitals, Medicaid|

Senate Bill Includes Provisions Vital to Many Hospitals

Last weekend the Senate passed a bill that could, if negotiated successfully with and adopted by the House, temporarily end the current federal government shutdown. Included in the Senate-passed bill are so-called health care extenders that are important to many hospitals, including: A delay in cuts in Medicaid disproportionate share hospital (Medicaid DSH) allotments to the states. A temporary extension of COVID-era telehealth flexibilities. Extension of the Medicare low-volume hospital and Medicare-dependent hospital programs. Extension of authorization for Medicare’s Acute Hospital at Home program. Extension of funding for Community Health Centers and teaching hospitals that operate graduate medical education (GME) [...]

joe2025-11-10T12:19:59-05:00November 10, 2025|Affordable Care Act, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for November 6

The following is the latest health policy news from the federal government for October 31 – November 6. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown; some are engaging in limited exceptions. Congress and the Shutdown Senate Majority Leader John Thune (R-SD) today told his caucus that he plans to bring the House-passed CR to yet another vote in the Senate on [...]

joe2025-11-06T21:35:12-05:00November 6, 2025|340b, Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

HHS Sets 340B Rebate Model

The Department of Health and Human Services’ Health Resources and Services Administration has approved eight plans from pharmaceutical companies to participate in its 340B Rebate Model Pilot Program. Currently, eligible 340B providers receive discounts when they purchase covered drugs but under the rebate model, covered entities continue to make purchases through their 340B wholesaler and will seek rebates from the pharmaceutical companies for the ten affected drugs dispensed to 340B-eligible patients after a purchase is made. Providers argue that the new approach creates a new, significant administrative burden for them and could affect their cash flow while pharmaceutical companies maintain [...]

joe2025-11-05T12:45:32-05:00November 6, 2025|340b|

New Methodology Helps Facilitate Medicaid Renewals

When the end of the COVID-19 pandemic led to the end of the moratorium on Medicaid disenrollments, states faced a daunting challenge: how to redetermine eligibility for 90 million people on their Medicaid rolls. The challenge grew even greater when it appeared that significant numbers of people were losing their Medicaid eligibility not because they no longer met the program’s eligibility criteria but for procedural reasons such as inability to gather the information needed to demonstrate eligibility, incomplete applications, or missing application deadlines. To address this problem, the Centers for Medicare & Medicaid Services tried a different approach, working with [...]

joe2025-11-04T16:35:21-05:00November 5, 2025|Centers for Medicare & Medicaid Services, COVID-19, Medicaid|

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