Bulletin Board2021-11-23T21:39:28-05:00

Bulletin Board

Bulletin Board

Improper Medicare Payments Down in FY 2019

The amount of improper Medicare payments made by the federal government fell $7 billion in federal fiscal year 2019, the Centers for Medicare & Medicaid Services reports. FY 2019 marked the third consecutive year that improper fee-for-service payments have fallen.  In FY 2018, improper payments accounted for 8.12 percent of Medicare fee-for-service spending but in FY 2019 that portion fell to 7.25 percent.  In FY 2019, CMS estimates that it made $28.9 billion in improper fee-for-service payments. $5.32 billion of the $7 billion reduction came through corrective actions in Medicare [...]

November 19, 2019|Categories: Medicare, Medicare reimbursement policy|Tags: |

Verma Addresses Medicaid Issues

Earlier this week, Centers for Medicare & Medicaid Services administrator Seema Verma spoke at a conference of the National Association of Medicaid Directors. In addition to discussing a proposed regulation posted earlier in the day that would introduce changes in the regulation of state financing of their Medicaid programs, Verma also addressed: Medicaid demonstration programs Medicaid work requirements a shift toward value-based payments better coordination of care for the dually eligible (individuals serve by both Medicaid and Medicare) enrollment issues improvements in the efficiency of the federal Medicaid bureaucracy Read [...]

MACPAC Posts Meeting Transcript

The Medicaid and CHIP Payment and Access Commission met in Washington, D.C. earlier this month.  The issues on MACPAC’s agenda were: state readiness to report mandatory core set measures analysis of buprenorphine prescribing patterns among advanced practitioners in Medicaid Medicaid’s statistical information system (T-MSIS) Medicaid disproportionate share hospital payment (Medicaid DSH) allotments Medicaid policies related to third-party liability Medicaid and maternal health A transcript of the MACPAC meeting is now available.  Find it here.  

Feds Open Door for Exemptions from Medicaid IMD Exclusion

New federal guidelines will make it easier for state Medicaid programs to cover mental health services provided in institutions for mental diseases (IMD). For years, Medicaid regulations greatly limited the ability of states to pay for care – generally, care related to substance abuse disorder treatment – provided in IMDs; this was generally known as the IMD exclusion.  The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, also known as the SUPPORT for Patients and Communities Act, which was passed in 2018, opened the [...]

November 13, 2019|Categories: Centers for Medicare & Medicaid Services, Medicaid|Tags: , |

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s November agenda were: congressional request on health care provider consolidation increasing the supply of primary care physicians redesigning the Medicare Advantage quality bonus program reforming the benchmarks in the Medicare Advantage payment system considerations for plans serving low-income beneficiaries in the restructuring of Medicare Part D post-acute care spending under the Medicare Shared Savings Program MedPAC is an independent congressional agency that advises Congress on issues involving [...]

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