Bulletin Board
Bulletin Board
Pennsylvania to Introduce Medicaid PDL on January 1
Starting on January 1, Pennsylvania will employ a preferred drug list for its Medicaid program – a list that applies to both fee-for-service and managed care patients. And as many as 150,000 of the state’s 2.8 million Medicaid beneficiaries may find themselves facing changes in their prescription drugs. The purpose of the PDL is to save money – an estimated $85 million a year, according to the Pennsylvania Department of Human Services, which administers the state's Medicaid program. While physicians may submit requests to the state for exemptions for specific [...]
Medicare Money for Nurse Practitioner and Physician Assistant Training?
Should Medicare offer graduate medical education money for nurse practitioner and physician assistant training? That was the subject of a recent inquiry by the U.S. Government Accountability Office. In a new report inspired by concern over the current physician shortage and the belief that making greater use of nurse practitioners might help relieve that shortage, the GAO examined whether expanding Medicare’s graduate medical education (GME) program to include resources for the training of nurse practitioners and physician assistants was practical or possible. As part of its research, the GAO reviewed [...]
A Look at Surprise Medical Bill Legislation
While Congress’s decision this week to put off addressing the surprise medical bill challenge until next year has disappointed many, that decision did not reflect any lack of ideas for what to do. At last count, various parts of Congress were considering four major surprise medical bill proposals: one from the Senate Health, Education, Labor and Pensions Committee, one from the House Energy and Commerce Committee, one from the House Ways and Means Committee, and a compromise proposal from the Senate HELP and House Energy and Commerce committees. Some have [...]
Good News and Bad for Hospitals on Outpatient Payments
A federal court has provided relief to hospitals that saw reduced Medicare payments for some outpatient services in 2019. But that relief is only partial. In response to a suit filed by several hospital groups, a federal court ruled that the Centers for Medicare & Medicaid services had illegally reduced Medicare payments for services provided in some hospital off-campus outpatient departments beginning on January 1, 2019 and ordered the federal government to repay the hospitals for the Medicare revenue they lost. The reduced payments were part of a new Medicare [...]
MACPAC Meets
The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The Medicaid and CHIP Payment and Access Commission kicked off its December meeting with highlights from its forthcoming issue of MACStats: Medicaid and CHIP Data Book, due out December 18, 2019. MACStats brings together statistics on Medicaid and State Children’s Health Insurance Program (CHIP) enrollment and spending, federal matching rates, eligibility levels, and access to care measures, which come from multiple sources. Later the [...]