joe, Author at DeBrunner & Associates

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, which contains [...]

joe2026-01-29T21:17:41-05:00January 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|

White House Unveils Health Care Plan

The White House has unveiled “The Great Healthcare Plan,” which it describes as “… a broad healthcare initiative that will slash prescription drug prices, reduce insurance premiums, hold big insurance companies accountable, and maximize price transparency in the American healthcare system.” The major components of the plan, and the key steps for each, are: lower drug prices slash prescription drug prices allow more over-the-counter medicines lower insurance premiums send the money directly to the American people fund cost-sharing reduction program cut kickback costs hold big insurance companies accountable create the “plain-English insurance” standard publish costs of overhead vs. claim payments [...]

joe2026-01-15T16:54:34-05:00January 19, 2026|health care reform|

Federal Health Policy Update for January 15

The following is the latest health policy news from the federal government for January 9-15. Some of the language used below is taken directly from government documents. The White House The White House has unveiled “The Great Healthcare Plan,” which it describes as “… a broad healthcare initiative that will slash prescription drug prices, reduce insurance premiums, hold big insurance companies accountable, and maximize price transparency in the American healthcare system.” The major components of the plan, and the key steps for each, are: lower drug prices slash prescription drug prices allow more over-the-counter medicines lower insurance premiums send the [...]

joe2026-01-15T16:13:09-05:00January 15, 2026|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare|

340B Pilot in Limbo After Court Acts – Twice

The future of the Department of Health and Human Services’ 340B Rebate Model Pilot Program is in jeopardy after two setbacks in federal court. A federal court issued a preliminary injunction preventing HHS from implementing the limited model, which was to test replacing the discounts that pharmaceutical companies provide to eligible providers participating in the section 340B prescription drug program when they purchase prescription drugs with post-purchase rebates for products they have already purchased. In issuing its injunction, the court wrote that … the Administrative Procedure Act’s (APA) arbitrary and capricious standard imposes vanishingly minimal requirements that a federal agency [...]

joe2026-01-13T16:50:39-05:00January 15, 2026|340b|

CBO Looks at Opioid Crisis

In light of the growing impact of the opioid crisis on public health, communities, and the economy, the Congressional Budget Office has examined possible approaches to addressing this crisis. In addition to steps such as reducing the supply of illicit opioids, increasing treatment for individuals in the criminal justice system, and enhanced monitoring of drug prescribers, the CBO envisions an important role for health care providers in any attack on the opioid crisis. Specifically, in its new report the CBO explores: expanding Medicaid coverage of treatment expanding use of telehealth for treatment increasing access to overdose reversal medications increasing treatment [...]

joe2026-01-14T12:19:40-05:00January 14, 2026|Medicaid, Telehealth|

Impact of Lost Health Insurance Subsidies Already Seen

The expiration of enhanced tax credits for the purchase of health insurance on Affordable Care Act exchanges is expected to put the cost of such plans beyond the reach of approximately 4.8 million people in 2026 and result in a significant increase in uninsured Americans. Just two weeks into the new year, the number of people who have purchased health exchange policies is reportedly 800,000 fewer than last year at this time. For a closer look at the anticipated impact of the loss of Affordable Care Act premium subsidies, see the following articles: NBC News – “ACA sign-ups fall as [...]

joe2026-01-13T15:17:01-05:00January 14, 2026|Affordable Care Act|

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