joe, Author at DeBrunner & Associates

Hospital at Home Program in Limbo

Medicare’s Acute Hospital Care at Home program is in limbo after the law authorizing it lapsed at the end of the 2025 federal fiscal year on September 30. As a result of this loss of authorization, CMS directed the more than 300 hospitals that participate in the program and care for seriously ill patients in their homes to discharge current participants or bring them back into their hospital. The program, created during the COVID-19 pandemic to free hospital beds for sicker patients who also were highly contagious, has been credited with lower mortality rates, reduced crowding in hospital emergency rooms, [...]

joe2025-10-15T12:52:33-04:00October 17, 2025|Medicare|

Federal Health Policy Update for October 16

The following is the latest health policy news from the federal government for October 10 - 16. 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. Congress and the Shutdown In its tenth attempt, the Senate today failed to pass a Republican-sponsored continuing resolution (CR). Republicans were unable to gain the 60 votes needed to pass the bill, winning Democratic support only from [...]

joe2025-10-16T16:38:02-04:00October 16, 2025|Affordable Care Act, Medicaid, Telehealth|

Medicaid DSH Cuts Have (Seemingly) Arrived

Cuts in Medicaid disproportionate share payments, mandated in 2010 under the Affordable Care Act to take effect in 2014 but delayed by Congress ever since, are now scheduled to begin taking effect because Congress’s latest extension of the delay lapsed with the end of the federal fiscal year on September 30. As a result, states – and hospitals that qualify for Medicaid DSH – are expected to see federal Medicaid DSH spending slashed by $8 billion a year for the next three years. Medicaid DSH payments are made to selected hospitals based on how many low-income patients they serve who [...]

joe2025-10-15T11:42:36-04:00October 16, 2025|Affordable Care Act, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

Protecting Consumers AND Providers? No Surprise

As intended, the No Surprises Act is protecting consumers from unexpected medical bills. But it’s also protecting someone else: providers. In the three years since the No Surprises Act’s Independent Dispute Resolution process was implemented, providers have won about 85 percent of cases. In 2023 and 2024, that amounted to more than $2 billion in additional payments. One aspect of the No Surprises Act that has been a surprise is the frequency with which parties are resorting to it. Originally projected to settle about 17,000 disputes a year, the process has seen more than three million disputes filed during its [...]

joe2025-10-14T15:29:39-04:00October 15, 2025|Uncategorized|

Hospital Financial Progress in Jeopardy

While hospitals and health systems in general continue to move closer to their pre-pandemic level of financial performance, they now face challenges that threaten to undermine that progress. While they have slowly gotten their labor costs under control, providers now face rising non-labor costs, including for drugs and supplies. Meanwhile, two recent policies enacted by Congress may pose an even greater threat. New limits on Medicaid eligibility threaten to transform manageable losses from under-reimbursement for Medicaid services into uncompensated care at the same time that the elimination of enhanced Affordable Care Act insurance premium subsidies could turn lower-income working families [...]

joe2025-10-14T14:19:03-04:00October 15, 2025|Affordable Care Act, Congress, hospitals, Medicaid|

Misinterpretation of Shutdown Plagues Telehealth

When federal authorization for Medicare-covered telehealth services lapsed at the end of the federal fiscal year on September 30, it was only supposed to affect traditional Medicare participants. But not everyone got the message. Some providers, confused about the lapse of Medicare authorization, are refusing to prescribe telehealth services for their non-Medicare patients. In addition, some health insurers are declining to cover telehealth services for their non-Medicare patients, misinterpreting the scope of the loss of Medicare authorization for telehealth care – something they should not be doing, according to a health insurance industry trade group. Older patients, patients with limited [...]

joe2025-10-14T11:45:35-04:00October 14, 2025|Medicare, Telehealth|

Federal Health Policy Update for October 9

The following is the latest health policy news from the federal government for October 3-9. 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. Congress and the Shutdown Today the Senate voted on separate Democratic- and Republican-led continuing resolutions (CRs) for the seventh time but again was unable to reach the 60-vote majority needed to pass a measure. Once again, only three Democratic senators [...]

joe2025-10-09T15:13:15-04:00October 9, 2025|Centers for Medicare & Medicaid Services, Congress, Medicaid, Medicaid managed care, Medicare|

States Looking to Medicaid For Spending Cuts?

Amid growing budget pressures, a number of states have reduced Medicaid payments to providers – and others are looking to Medicaid as a possible source of savings. So far, Idaho and North Carolina have reduced Medicaid payments to providers while Illinois is looking at Medicaid, among other sources, in the face of its governor’s desire to reduce spending by four percent in the coming year. In addition, Indiana is pursuing a complex process of increasing state Medicaid payments to some providers through state directed payments but the net effect, according to hospital groups, could be an actual reduction of nearly [...]

joe2025-10-08T11:42:46-04:00October 9, 2025|Medicaid|

States Mull Pursuit of Rural Health Transformation Money

Support to grow their health care workforce, including new or expanded medical education programs to attract doctors and nurses. Doing more to address chronic medical conditions. Better coordination of care and greater use of technology. Making greater use of telehealth. Improving the local transportation infrastructure as a means of improving access to care. These are among the ideas that health care officials from almost every state discussed recently at a networking workshop held last week by the Health Policy Futures Lab to discuss how states might approach crafting proposals seeking a portion of the first half of the $50 billion [...]

joe2025-10-07T15:50:11-04:00October 8, 2025|Medicaid, Telehealth|

Medicaid Work Rule May Hit Chronically Ill

The introduction of a work requirement for Medicaid eligibility may have the greatest impact on Medicaid beneficiaries with chronic illnesses. According to a new analysis of the approximately five million people who are likely to lose their Medicaid eligibility between now and 2034 because of the new work requirement introduced in the FY 2026 budget reconciliation bill (the “One Big Beautiful Act Bill,”) more than 85 percent have at least one chronic medical condition and more than 40 percent have at least three such conditions. The percentages rise, moreover, among current Medicaid beneficiaries over the age of 50. Some of [...]

joe2025-10-07T13:44:24-04:00October 8, 2025|Medicaid|

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