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Federal Health Policy Update for September 11

The following is the latest health policy news from the federal government for September 5-11. Some of the language used below is taken directly from government documents. Congress With fewer than three weeks until the end of the federal fiscal year, congressional leaders are beginning to devise a strategy to avoid a federal government shutdown on October 1. Whatever strategy they ultimately adopt will certainly involve some form of continuing resolution (CR). Some conservatives in Congress would like to see a full-year CR that would keep funding at current levels [...]

September 11, 2025|Categories: 340b, Affordable Care Act, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|Tags: 340B, Acute Hospital Care at Home program, advanced premium tax credits, approved Medicaid state plan amendments, approved state directed Medicaid payments, CMS guidance on Medicaid managed care state directed payments, community mental health centers, Congressional Budget Office report on 340B, enhanced premium tax credits, FDA and prescription drug warning requirements, Federal Trade Commission and noncompete agreements, FTC and noncompete agreements, MAHA, Make America Healthy Again Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care state directed payments, Medicare Part B and skin substitutes, Medicare sequestration, MLN Connects, One Big Beautiful Bill Act, PAYGO, proposed 2026 Medicare physician fee schedule regulation, telehealth|

MedPAC Meets

MedPAC’s commissioners held their latest public meetings on Thursday, September 4 and Friday, September 5. The subjects on the meetings’ agenda were: Medicare payment operations and improving payment accuracy oversight needed to ensure Medicare’s sustainability: a report from the Government Accountability Office context for Medicare payment policy access to hospice and certain services under the hospice benefit for beneficiaries with end-stage renal disease or cancer the association between changes in Medicare Advantage enrollment and hospital finances Go here for summaries of the issues and key points and links to the [...]

September 10, 2025|Categories: Centers for Medicare & Medicaid Services, Medicare, Medicare reimbursement policy, MedPAC|Tags: Medicare Advantage and hospital financial performance, Medicare and hospice services and payments, Medicare payment accuracy, Medicare Payment Advisory Commission, MedPAC, MedPAC meeting|

CMS Tinkers With Models

The Centers for Medicare & Medicaid Services has announced changes in two of its Medicare accountable care models: the Achieving Healthcare Efficiency Through Accountable Design (AHEAD) Model and the Transforming Episode Accountability (TEAM) Model. The AHEAD Model is a state total cost of care model that seeks to drive state and regional health care transformation and multi-payer alignment with the goals of improving the total health of the population involved, promoting competition and choice, enhancing prevention, and empowering patients. Under the changes, states must implement at least two policies focused [...]

September 9, 2025|Categories: Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Medicare, Medicare post-acute care, Medicare reimbursement policy|Tags: Achieving Healthcare Efficiency Through Accountable Design model, AHEAD Model, Medicare 3-night rule, Transforming Episode Accountability Model TEAM model|

Preparations for Rural Health Transformation Program Continue

When Congress enacted its FY 2025 budget reconciliation bill – the so-called “One Big Beautiful Bill” – it recognized that the Medicaid cuts in that legislation could have a damaging effect on some health care providers and the communities they serve and created a five-year, $50 billion “Rural Health Transformation Program” designed to help protect rural hospitals from some of the damage those cuts are expected to cause. Now, federal regulators are working to bring that program to life. The Centers for Medicare & Medicaid Services, which will administer the [...]

September 8, 2025|Categories: Medicaid|Tags: Center for Medicare & Medicaid Services, Medicaid cuts, Rural Health Transformation Program|

Federal Health Policy Update for September 4

The following is the latest health policy news from the federal government for August 29 – September 4. Some of the language used below is taken directly from government documents. Congress The House and Senate have returned to Washington D.C., where their focus has turned to funding for the federal government, which expires on September 30. Senior appropriators predict that Congress will pass a continuing resolution (CR) to keep the government open through at least mid-November. We expect any CR to include a number of health care extenders for programs [...]

September 4, 2025|Categories: Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|Tags: Achieving Healthcare Efficiency Through Accountable Design model, Acute Hospital Care at Home program, AHEAD Model, approved Medicaid state plan amendments, catastrophic health insurance, CMS technical expert panel, electronic clinical quality measures eCQMs, enhanced premium tax credits, health care extenders, health data blocking, Health Data Technology and Interoperability rule, health insurance hardship exemption, HT1-4 rule, Medicaid disproportionate share, Medicaid DSH, Medicare dependent hospital program, Medicare low-volume hospital program, Medicare Payment Advisory Commission, Medicare sequestration, MedPAC, MedPAC and end-stage renal disease payments, MLN Connects, PAYGO, Rural Health Transformation Program, TEAM model, telehealth, Transforming Episode Accountability Model|

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