joe, Author at DeBrunner & Associates

CMS Fleshes Out “Medical Frailty” Criterion for Medicaid Eligibility

When Congress included major reductions in Medicaid eligibility in last year’s budget reconciliation bill – H.R. 1, often referred to as the “One Big Beautiful Bill Act” – it included one criterion for Medicaid eligibility that immediately proved challenging. While the new law requires individuals to work or participate in “community engagement” activities such as attending school or performing volunteer work” as a condition of Medicaid eligibility, it offered an exception to this requirement: those found to be “medically frail.” The law, however, did little to define what constitutes medical frailty beyond defining as medically frail those who are blind [...]

joe2026-09-15T16:39:05-04:00September 16, 2026|Medicaid|

The Declining Number of Hospital Maternity Units

The number of hospitals with maternity units has been declining for years – and there is reason to fear that decline will continue in the near future. According to a recent analysis: More than 700 hospitals closed their maternity units between 2010 and 2024. Today, nearly half of all U.S. hospitals do not have a maternity unit. The shortage is especially great in rural areas, where 57 percent of rural hospitals have no maternity unit. Maternity unit closures hit hospitals especially hard in rural Alabama, Arkansas, Indiana, and Wisconsin. Among the reasons for the closing of so many hospital maternity [...]

joe2026-09-10T17:08:50-04:00September 14, 2026|hospitals, Medicaid|

EMTALA Citations on the Rise

Federal citations for hospital violations of EMTALA requirements have risen in recent years. Under the Emergency Medical Treatment and Labor Act, hospitals are required to screen and stabilize all their emergency department patients regardless of their ability to pay for their care. According to data from the Centers for Medicare & Medicaid Services, the proportion of hospitals cited for EMTALA violations rose from four percent of all inspected hospitals in 2019 to 6.9 percent in 2024 – the highest proportion since at least 2010. The proportion declined to 6.6 percent last year and appears to be trending downward again so [...]

joe2026-09-09T12:38:52-04:00September 11, 2026|hospitals|

Federal Health Policy Update for September 10

Don’t Miss: Energy and Commerce to weigh multiple health care bills HRSA shares upcoming 340B administrative changes CMS continues distributing Rural Health Transformation Program $$$ The following is the latest health policy news from the federal government for September 4-10. Some of the language used below is taken directly from government documents. The White House The White House announced that the federal government will issue refunds of $500 a person to nearly one million Americans who it says were overcharged for Affordable Care Act exchange health plans because their premiums included user fees that were charged to cover the cost [...]

joe2026-09-10T14:54:12-04:00September 10, 2026|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, CMMI, Congress, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Administrative Changes Coming to 340B

The Health Resources and Services Administration has released new information about changes coming to its 340B Office of Pharmacy Affairs Information System on October 1. According to the agency, the changes “… support program integrity, transparency, and operational efficiency by enhancing several registration, recertification, and change request processes.” Among the areas that will see changes are: documentation requirements for some eligible entities hospital terminology changes requirements for additional information from family planning covered entities The October changes do not, the agency notes, “… change the underlying statutory eligibility requirements for participation in the 340B Program.” Learn more about administrative changes [...]

joe2026-09-08T14:24:28-04:00September 10, 2026|340b|

MedPAC Meets

Members of the Medicare Payment Advisory Commission held their latest public meeting on Thursday, September 3 and Friday, September 4. The subjects on the meeting’s agenda were: context for Medicare payment policy issues and potential policy directions in Part D workplan: ambulatory surgical centers examining use of post-acute care services by beneficiaries in fee-for-service Medicare and Medicare Advantage Accuracy of Medicare Advantage risk adjustment at the plan level Go here for summaries of the issues and key points and links to the presentations delivered by MedPAC’s staff and go here for a transcript of the two-day session. MedPAC is an independent [...]

joe2026-09-09T12:41:01-04:00September 9, 2026|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Medicare Makes COVID-Era Telehealth Flexibility Permanent

The Centers for Medicare & Medicaid Services has made permanent a change in Medicare telehealth policy that was introduced as a temporary flexibility during the COVID-19 public health emergency: permitting most providers to deliver telehealth services from their homes without listing their home address on their Medicare enrollment. According to the new CMS advisory document “Understanding Telehealth and Teleradiology Enrollment,” If you provide telehealth services from your home, but have a physical practice location, you do not need to report your home address on your Medicare enrollment application. You can enroll and bill from your physical practice location as if [...]

joe2026-09-03T15:06:39-04:00September 8, 2026|Medicare, Telehealth|

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 [...]

joe2026-10-07T11:46:37-04:00September 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|

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