joe, Author at DeBrunner & Associates

HHS Releases Proposed Budget

The Department of Health and Human Services has released a new, expanded version of its proposed FY 2026 budget. In some areas this version provides more detail than the administration shared in early May when it released a so-called “skinny budget” and some aspects of the budget proposal differ from the May release. Highlights of the most recent proposal include: A reduction of 25 percent, from $126 billion to $94.7 billion, in HHS’s overall discretionary (non-mandatory) spending. The consolidation of HHS’s 28 current operating divisions into 15 divisions. A reduction of $661 million, or 11 percent, in discretionary spending for [...]

joe2025-06-11T12:29:44-04:00June 12, 2025|340b, Centers for Medicare & Medicaid Services|

Administration Targets State Directed Medicaid Payments

The White House has issued a presidential memorandum on “Eliminating Waste, Fraud, and Abuse in Medicaid” that cites Medicaid “state-directed payments” as a form of waste, fraud, and abuse. According to the memorandum, states use state directed payments to pay more than Medicare rates for some Medicaid-covered services – something the memorandum suggests is contrary to current practice because “…billable costs for such care were historically capped at the same level that healthcare providers could receive from Medicare.” This assertion comes despite a 2024 regulation that set the payment limit for state directed payments at the average commercial rate and [...]

joe2025-06-11T10:22:01-04:00June 11, 2025|Medicaid, Medicaid managed care, Medicaid regulations|

CMS Charts Medicare’s Tech Future

In the wake of issuing a request for information asking stakeholders how the agency can better serve Medicare beneficiaries, the Centers for Medicare & Medicaid Services has begun charting its future use of technology by laying out some of the objectives of such an undertaking. In a recent news release, CMS identified the following objectives: Building a dynamic, interoperable national provider directory. Bringing modern identity verification processes to Medicare.gov to streamline credentials across the healthcare system. Expanding functionality of CMS’ Blue Button 2.0 patient access application programming interface (API). Transitioning CMS’s Data at the Point of Care pilot to general availability. [...]

joe2025-06-05T15:53:32-04:00June 10, 2025|Medicare|

Hospital Charity Care, Debt Collection Practices Vary

An analysis of the charity care policies of 2500 hospitals found considerable variation in their practices and in their efforts to collect unpaid bills. According to a review by the Lown Institute, most hospitals offer charity care but the income thresholds for qualifying for such assistance vary widely from hospital to hospital, from as low as household income of 100 percent of the federal poverty level to as much as 600 percent of the federal poverty level. Those standards vary, moreover, even in the same community, with neighboring hospitals sometimes having considerable differences in their thresholds for providing some or [...]

joe2025-06-05T14:41:09-04:00June 9, 2025|hospitals|

Federal Health Policy Update for June 5

The following is the latest health policy news from the federal government for May 30 to June 5. Some of the language used below is taken directly from government documents. Congress Congress returned to Washington D.C., where Republican senators continue to work on their version of a reconciliation bill with a goal of passage by the full Congress by July 4. Some Senate committees have begun releasing their portions of the bill but the committees with jurisdiction over Medicaid – the Finance and Health, Education, Labor, and Pensions (HELP) committees – have not committed to a timeline for their bills. [...]

joe2025-06-05T16:50:48-04:00June 5, 2025|Congress, hospitals, Medicaid, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for May 29

The following is the latest health policy news from the federal government for May 23-29. Some of the language used below is taken directly from government documents. Congress The House and Senate are out of Washington, D.C. this week for the Memorial Day holiday and will return to Washington on June 3. Senate Republican staff is working on the House-passed reconciliation bill to identify provisions that may need to change or be excluded to comply with the Senate’s rules for reconciliation bills. At the same time, some Republican senators have expressed opposition to the House reconciliation bill; some maintain that [...]

joe2025-05-29T15:36:56-04:00May 29, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for May 22

The following is the latest health policy news from the federal government for May 16-22. Some of the language used below is taken directly from government documents. Congress: Reconciliation Early Thursday morning the House of Representatives passed its version of an FY 2025 budget reconciliation bill by a vote of 215-214. The bill underwent a number of changes during the hours before its passage and its health care provisions now include $800 billion in Medicaid cuts over the next ten years. The Congressional Budget Office projects that the bill, mostly because of the Medicaid cuts, will lead to 8.6 million [...]

joe2025-05-23T10:22:33-04:00May 23, 2025|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, COVID-19, deficit reduction, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

Innovation Center to Steer New Course

The Centers for Medicare & Medicaid Services’ Center for Medicare and Medicaid Innovation has announced that it will take a new approach to developing and testing new models of health care delivery – an approach designed to be more MAHA-oriented. The Innovation Center intends to place a greater emphasis on disease and chronic condition prevention built around what it calls “three interrelated pillars:” promoting evidence-based prevention, empowering people to achieve their health goals, and driving choice and competition. The agency says it “…will focus on models that show the greatest promise for generating savings and improving quality.” Specifically, the Innovation [...]

joe2025-05-15T16:13:40-04:00May 19, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare|

Federal Health Policy Update for May 15

The following is the latest health policy news from the federal government for May 9-15. Some of the language used below is taken directly from government documents. Congress: Reconciliation House Energy and Commerce Committee Charged with finding $880 billion in federal spending cuts over the next ten years, the House Energy and Commerce Committee this week produced legislative language to be included in a House reconciliation bill that would achieve that objective. The committee’s cost-cutting provisions include: Freezing state Medicaid provider taxes at their current level, prohibiting the establishment of new provider taxes, modifying the criteria CMS uses to determine [...]

joe2025-05-15T17:19:56-04:00May 15, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, deficit reduction, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations, Medicare, Medicare cuts, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for May 8

The following is the latest health policy news from the federal government for May 2-8. Some of the language used below is taken directly from government documents. Congress Reconciliation Over the past several days the political gravity surrounding Medicaid cuts has begun to shift slightly. Moderate Republicans have been pushing back more forcefully and more loudly against such cuts, with some saying they will not support more than work requirements and increased enforcement checks for eligibility. Opposition to most Medicaid cuts led the Energy and Commerce Committee to delay a markup of its reconciliation bill planned for this week to [...]

joe2025-05-08T16:50:48-04:00May 8, 2025|Accountable Care Organization, Alternative payment models, Congress, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

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