joe, Author at DeBrunner & Associates

Federal Health Policy Update for September 3

Don’t Miss: 340B data reporting requirements for Medicare Part D claims data – repository opens October 1 CMS permanently permits providers to deliver telehealth from home without listing home address on Medicare enrollment application The following is the latest health policy news from the federal government for August 28-September 3. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services (CMS) CMS is preparing to launch a new Medicare Part D Claims Data 340B Repository on October 1. The 340B data repository will be a centralized, federally managed information system that will [...]

joe2026-09-03T17:26:34-04:00September 3, 2026|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, hospitals, Medicaid, Medicare, Medicare regulations, MedPAC, Telehealth|

CMS Sets Soft Launch for 340B Data Repository

The Centers for Medicare & Medicaid Services will launch a new Medicare Part D Claims Data 340B Repository on October 1. The agency’s 340B data repository will be a centralized, federally managed information system that will collect, store, and process specific claim-level utilization data for prescription drugs dispensed under the Medicare Part D benefit that also are subject to discounts through the 340B Drug Pricing Program. CMS developed the repository to support implementation of the Medicare Prescription Drug Inflation Rebate Program, which was mandated by the Inflation Reduction Act of 2022. Under this program, the federal government must exclude drug [...]

joe2026-09-02T12:49:27-04:00September 3, 2026|340b, Medicare|

With Medicaid Enrollment Down, More Patients Paying Cash

With roughly five million Americans losing their Medicaid coverage since early 2025 as a result of the expiration of COVID-inspired eligibility expansions and the introduction of new, more stringent eligibility criteria, more people, faced with the need for health care and without their Medicaid safety net, are turning to cash to pay for the services they need. According to new data, 7.6 percent of ER patients paid cash in the second quarter of 2026, up from 5.5 percent in 2022. Meanwhile, the number of cash-paying, uninsured inpatients rose from 1.9 percent to 2.6 percent over the same period of time. [...]

joe2026-09-01T15:54:46-04:00September 2, 2026|hospitals, Medicaid|

Prior Authorization Remains a Challenge

Getting timely prior authorization for needed medical care continues to pose a problem for patients and providers. Despite federal government action to address prior authorization concerns associated with health care programs it oversees – Medicare Advantage, Medicaid and CHIP fee-for-service and managed care plans, and Affordable Care Act Marketplace plans – and the insistence of some insurers that they have been addressing the issue, problems persist. According to a recent analysis by KFF (quoted directly): Medicare Advantage insurers denied 12% of standard prior authorization requests, Medicaid managed care insurers denied 14%, and ACA Marketplace insurers denied 18%. Denial rates for [...]

joe2026-08-27T16:21:27-04:00September 1, 2026|Affordable Care Act, Medicaid, Medicaid managed care, Medicare|

MedPAC Looks to the Year Ahead

In anticipation of the start of its 2026-2027 public meeting cycle next month, the Medicare Payment Advisory Commission has published a summary of its anticipated analytic agenda for that period. The major components of that agenda are: recent trends in Medicare Part D (prescription drug) spending the processes and information involved in beneficiary enrollment in Medicare the effect of Medicare’s quality measurement and value-based purchasing programs on quality and value the adequacy of Medicare fee-for-service payments and payment recommendations for the upcoming year further analysis of the Medicare Advantage program Learn more from this MedPAC message to its constituents.

joe2026-08-27T11:30:47-04:00August 31, 2026|Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for August 27

Don’t Miss: Homeland Security proposes new six-figure H-1B visa fee CMS announces refinement of critical access hospital status evaluation HHS seeks feedback on relative of childhood vaccines The following is the latest health policy news from the federal government for August 21-27. Some of the language used below is taken directly from government documents. Congress The House will return from recess next Monday, August 31 and the Senate returns on September 14. Funding for the federal government expires after September 30. H-1B Visas The Department of Homeland Security has issued a notice of proposed rulemaking calling for a $103,265 fee [...]

joe2026-08-27T16:40:49-04:00August 27, 2026|Centers for Medicare & Medicaid Services, Medicaid, Medicare, Medicare reimbursement policy, MedPAC|

Proposed Visa Fee Brings Mixed News for Health Care Interests

The Department of Homeland Security’s proposed $103,265 fee for all H-1B cap-subject visa petitions is good news for some health care organizations and not-so-good news for others – and the communities they serve. Under the proposal, the additional fee would not apply to H-1B petitions that are not subject to the cap – including those eligible for the advanced degree exemption – such as petitions filed by certain non-profit research organizations, governmental research organizations, and institutions of higher education. On the other hand, a new, six-figure fee – which must be paid when applying for the visa – could create [...]

joe2026-08-26T12:31:08-04:00August 27, 2026|hospitals|

The Implications of New Limits on Medicaid Provider Taxes

Last year’s federal budget reconciliation law, in addition to introducing nearly a trillion dollars in federal health care spending cuts over the next decade, took aim at a tool state governments consider vital in financing their Medicaid programs: provider taxes. For years, states have used provider taxes, typically on some aspect of hospital activity, to help finance their share of their Medicaid programs; currently, 49 of the 50 states have such taxes. Among other benefits, using provider taxes in this manner has enabled states to avoid using more general fund money for this purpose. But the 2025 law imposes new [...]

joe2026-08-25T13:45:21-04:00August 26, 2026|Medicaid, Medicaid regulations|

Infants, Toddlers Increasingly Dependent on Public Health Insurance

A new study highlights the growing dependence of families on public health insurance programs – Medicaid and the Children’s Health Insurance Program – to pay for care for their infants and children. According to a new analysis by the Georgetown University McCourt School for Public Policy, Medicaid and the Children’s Health Insurance Program (CHIP) cover 4 in 10 (39.7%) children under age 3. For families earning less than 200% of the federal poverty level—about $54,640 for a family of three—Medicaid and CHIP are even more critical sources of coverage, insuring approximately three-quarters (74.6%) of infants and toddlers. Other major findings, [...]

joe2026-08-20T15:52:49-04:00August 24, 2026|Medicaid|

Federal Health Policy Update for August 20

Don’t Miss: Latest No Surprises Act/Independent Dispute Resolution news Dept of Homeland Security issues guidance on “public charge” The following is the latest health policy news from the federal government for August 14-20. Some of the language used below is taken directly from government documents. Congress Thirty Senate Democrats have written to HHS Secretary Kennedy seeking to reverse the cancellation of health research grants administered by the Agency for Healthcare Research and Quality (AHRQ). For more information, see the letter here. Congress remains in recess; the House is expected to return on August 31 and the Senate on September 14. [...]

joe2026-08-20T15:55:42-04:00August 20, 2026|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

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