joe, Author at DeBrunner & Associates

CMS Fleshes Out Medicaid Work Requirement

The Centers for Medicare & Medicaid Services has issued additional guidance to the states on how to implement the work and community engagements established as part of the criteria for Medicaid eligibility under H.R. 1, commonly known as the One Big Beautiful Bill Act, which was signed into law in July. The requirements seek to connect able-bodied, working-age adults with work and community engagement activities and reduce inappropriate Medicaid enrollment. The states are required to implement these requirements by January 1, 2027 but may do so sooner if they wish. In providing this guidance, CMS enumerates four major principles, quoted [...]

joe2025-12-10T12:57:33-05:00December 11, 2025|Centers for Medicare & Medicaid Services, Medicaid|

MedPAC Discusses Preliminary 2027 Rate Recommendations

The members of the Medicare Payment Advisory Commission met virtually last week and reviewed and discussed preliminary proposals for 2027 Medicare rates and other Medicare payment issues. Leading the agenda for the two days of meetings was a review of the adequacy of current Medicare payments and discussion about rate 2027 rate recommendations for: hospital inpatient and outpatient services physician and other health professional services inpatient rehabilitation facility services skilled nursing facility services home health care services hospice services outpatient dialysis services MedPAC members also discussed: their mandated report on rural emergency hospitals an update on site-neutral payments, including the [...]

joe2025-12-10T08:11:11-05:00December 10, 2025|Congress, hospitals, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Urban Safety-Net Hospitals Most Vulnerable to Looming Health Care Cuts

While a great deal of attention has been paid to the potential implications for rural hospitals of the coming $1 trillion in federal health care spending cuts over the next decade, it turns out that urban safety-net hospitals, not rural hospitals, may be even more vulnerable to the effects of these cuts. According to an analysis by the New York Times and Harvard’s T.H. Chan School of Public Health, of the 109 hospitals in the country that will be most vulnerable to these cuts, 85 percent are urban safety-net hospitals and not rural hospitals. Three factors drive this vulnerability: their [...]

joe2025-12-04T16:51:55-05:00December 8, 2025|Congress, hospitals, Medicaid|

Federal Health Policy Update for December 4

The following is the latest health policy news from the federal government for November 21 through December 4. Some of the language used below is taken directly from government documents. Congress Congress is back in session to discuss the Affordable Care Act tax credits set to end on December 31and other extenders that will expire on January 30, 2026 along with the latest continuing resolution (CR). Members continue to negotiate potential solutions to the expiring enhanced Affordable Care Act premium subsidies but there is no consensus on whether or how to address the expiring benefit. Senate Majority Leader Thune (R-SD) [...]

joe2025-12-04T15:05:28-05:00December 4, 2025|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

CMS Offers Preliminary Thoughts on Medicaid Provider Taxes

In a message to state Medicaid programs, the Centers for Medicare and Medicaid Services has laid preliminary groundwork for how it intends to interpret new limits on Medicaid provider taxes enacted under H.R. 1, a law passed in July that brought significant changes to U.S. tax law and major changes in Medicare and especially Medicaid; the bill also has become known as the “One Big Beautiful Bill Act.” With all but one state using Medicaid provider taxes to help finance their share of Medicaid spending and many states increasingly dependent on such taxes, this issue is of considerable importance to [...]

joe2025-11-20T16:05:02-05:00November 24, 2025|Medicaid, Medicaid regulations|

Federal Health Policy Update for November 20

The following is the latest health policy news from the federal government for November 14-20. Some of the language used below is taken directly from government documents. Medicare and Telehealth In guidance issued Thursday afternoon, CMS notes that on November 6 it instructed the MACs to return a subset of telehealth claims submitted on or before November 10 that at that time were no longer payable because the statutory provisions temporarily suspending various Medicare telehealth requirements expired on October 1 or were claims CMS could not identify as payable under current law. Now, practitioners may resubmit those returned claims to [...]

joe2025-11-21T11:57:00-05:00November 20, 2025|Uncategorized|

Medicare, Medicaid Regulations Logjam Should Soon End

The shutdown of the federal government brought the usual flow of Medicare and Medicaid regulations to an almost complete halt. Now that the shutdown has ended, the logjam should end fairly quickly – and with a sense of urgency. Currently, a number of major Medicare and Medicaid regulations remain with the Office of Management and Budget for review. Even though the shutdown has now ended, it is not yet clear when they will be addressed. By statute, the following regulations must be implemented by January 1. CY 2026 Hospital Outpatient Prospective Payment System Policy Changes and Payment Rates and Ambulatory [...]

joe2025-11-13T17:00:30-05:00November 18, 2025|Alternative payment models, Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Health Care and the End of the Shutdown

Passage last week of a continuing resolution to fund the federal government brought the 43-day shutdown to an end – and relief for many health care organizations and the people and communities they serve. The final continuing resolution, which extended federal funding through the end of January of next year, includes: Restoring the delay of reductions of Medicaid disproportionate share hospital (Medicaid DSH) payments. Extending authorization for the Medicare Acute Hospital Care at Home program and Medicare telehealth flexibilities. Extending the low-volume hospital adjustment program and the Medicare-dependent hospital program all through that same date. The bill waives the pay-as-you-go [...]

joe2025-11-13T16:30:32-05:00November 17, 2025|Affordable Care Act, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for November 13

The following is the latest health policy news from the federal government for November 7-13. Some of the language used below is taken directly from government documents. Please note that during the federal government shutdown, most HHS and other health care-related agencies, with limited exceptions, engaged in little public activity such as announcements, the publication of new regulations, and updating their web sites. Now that the shutdown has ended, normal activity can be expected to resume shortly. The End of the Federal Government Shutdown On Wednesday night the House passed the Senate-amended version of the continuing resolution (CR) in a [...]

joe2025-11-13T15:20:05-05:00November 13, 2025|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicare, Medicare reimbursement policy, Telehealth|

Labor and Delivery Situation Worsens at Rural Hospitals

Rural America continues to experience the loss of hospital labor and delivery services. With 2025 not yet over, more rural hospitals – 27 – have closed or are in the process of closing their labor and delivery services than did so in 2024 (21). As a result, only 41 percent of the nearly 2400 rural hospitals in the country today provide labor and delivery services. Of the remaining 900 hospitals still providing these services, 127 of them – 13 percent – are considered to be at risk of closing those services. As a result of this shortage, pregnant women face [...]

joe2025-11-12T12:40:41-05:00November 13, 2025|hospitals|

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