joe, Author at DeBrunner & Associates

Applications Highlight Rural Health Targets

Chronic disease prevention. Greater access to mobile health services. Rural clinician recruitment. Improved emergency medical services. Technological advancements. These are among the priorities articulated by rural states in their applications for federal Rural Health Transformation Program funds according to a Stateline analysis of the materials submitted by ten states with large rural populations. All 50 states submitted applications for a piece of the $50 billion pool that was part of the “One Big Beautiful Bill Act” to help offset some of the massive Medicaid cuts that were a major part of that legislation. Applicants for the Rural Transformation Program money [...]

joe2025-11-12T11:42:39-05:00November 12, 2025|Centers for Medicare & Medicaid Services, Medicaid|

Hospitals Dealing With More Self-Pay Patients, Uncompensated Care

Driven by patients’ loss of health insurance, coverage gaps in insurance policies, an increase in high-deductible plans, and the post-COVID changes in Medicaid eligibility, hospitals are encountering growing numbers of uninsured and self-pay patients. In response, they are pursuing ways to improve billing and bill collection while seeking upfront payments from patients with questionable or no coverage, employing patient navigators, and using AI technology. Learn more about the recent increase in self-pay and uninsured patients and how hospitals are responding to this challenge from the Modern Healthcare article “How hospitals are tackling the surge of self-pay patients” (subscription required).

joe2025-11-10T13:13:18-05:00November 11, 2025|hospitals, Medicaid|

Senate Bill Includes Provisions Vital to Many Hospitals

Last weekend the Senate passed a bill that could, if negotiated successfully with and adopted by the House, temporarily end the current federal government shutdown. Included in the Senate-passed bill are so-called health care extenders that are important to many hospitals, including: A delay in cuts in Medicaid disproportionate share hospital (Medicaid DSH) allotments to the states. A temporary extension of COVID-era telehealth flexibilities. Extension of the Medicare low-volume hospital and Medicare-dependent hospital programs. Extension of authorization for Medicare’s Acute Hospital at Home program. Extension of funding for Community Health Centers and teaching hospitals that operate graduate medical education (GME) [...]

joe2025-11-10T12:19:59-05:00November 10, 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 6

The following is the latest health policy news from the federal government for October 31 – November 6. 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; some are engaging in limited exceptions. Congress and the Shutdown Senate Majority Leader John Thune (R-SD) today told his caucus that he plans to bring the House-passed CR to yet another vote in the Senate on [...]

joe2025-11-06T21:35:12-05:00November 6, 2025|340b, Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

HHS Sets 340B Rebate Model

The Department of Health and Human Services’ Health Resources and Services Administration has approved eight plans from pharmaceutical companies to participate in its 340B Rebate Model Pilot Program. Currently, eligible 340B providers receive discounts when they purchase covered drugs but under the rebate model, covered entities continue to make purchases through their 340B wholesaler and will seek rebates from the pharmaceutical companies for the ten affected drugs dispensed to 340B-eligible patients after a purchase is made. Providers argue that the new approach creates a new, significant administrative burden for them and could affect their cash flow while pharmaceutical companies maintain [...]

joe2025-11-05T12:45:32-05:00November 6, 2025|340b|

New Methodology Helps Facilitate Medicaid Renewals

When the end of the COVID-19 pandemic led to the end of the moratorium on Medicaid disenrollments, states faced a daunting challenge: how to redetermine eligibility for 90 million people on their Medicaid rolls. The challenge grew even greater when it appeared that significant numbers of people were losing their Medicaid eligibility not because they no longer met the program’s eligibility criteria but for procedural reasons such as inability to gather the information needed to demonstrate eligibility, incomplete applications, or missing application deadlines. To address this problem, the Centers for Medicare & Medicaid Services tried a different approach, working with [...]

joe2025-11-04T16:35:21-05:00November 5, 2025|Centers for Medicare & Medicaid Services, COVID-19, Medicaid|

Federal Health Policy Update for October 30

The following is the latest health policy news from the federal government for October 24-30. 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 The federal government remains shut down and the Senate expects to leave Washington today without another vote on the House-passed continuing resolution (CR), ensuring that the shutdown will continue into next week. Republican leaders believe [...]

joe2025-10-31T12:15:23-04:00October 30, 2025|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, Medicaid, Medicare|

CMS Employees Return to Work

The Centers for Medicare & Medicaid Services has recalled 3000 employees – 47 percent of its workforce – furloughed earlier this month when the federal government shutdown began. In a published report, a CMS spokesperson explained that “In order to best serve the American people amid the Medicare and Marketplace open enrollment seasons, CMS is temporarily calling back all furloughed employees on Monday, October 27.” In addition to working on Medicare and Marketplace open enrollment, some of the employees returning to work also will participate in the review of applications for Rural Health Transformation Program funding. The deadline for states [...]

joe2025-10-29T11:35:05-04:00October 30, 2025|Centers for Medicare & Medicaid Services, Medicare|

Senate Committee Looks at 340B

Last week the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing on the 340B Drug Pricing Program, which provides discounted prescription drugs to eligible health care providers, known as "covered entities," to help them serve low-income and uninsured patients. In recent years the 340B program has become more controversial as it has grown and as pharmaceutical companies object more strenuously to the discounts they are required to provide to participating providers. In addition, some critics charge that the savings providers gain from 340B discounts are not consistently reinvested in care for low-income and uninsured patients while those [...]

joe2025-10-28T15:50:27-04:00October 29, 2025|340b, Congress|

Impact of H-1B Visa Fee on Hospitals in Underserved and Rural Areas

The new $100,000 fee for H-1B visas is expected to detract from the ability of providers in low-income and rural areas to serve their communities. Providers – especially hospitals – in such areas typically operate on very low margins and always have trouble recruiting physicians and other highly skilled providers and often turn to international medical graduates in search of help. In fact, a 2021 study published by the National Institutes of Health reported that nearly two-thirds of international medical graduates practiced in areas designated as health professional shortage areas or medically underserved areas, with nearly half practicing in rural [...]

joe2025-10-28T11:46:55-04:00October 28, 2025|hospitals|

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