Bulletin Board
Bulletin Board
MedPAC Meets
MedPAC’s commissioners held their latest public meeting on Thursday, April 9 and Friday, April 11. The subjects on the meeting’s agenda were: improving payment incentives in Medicare analysis of regional benchmarks and benchmark-plan availability in the Part D prescription drug plan market preferred networks and pharmacy access in Part D estimated association between Medicare Advantage enrollment and hospitals’ and post-acute care providers’ finances information sources that beneficiaries use to make Medicare enrollment decisions institutional special-needs plans: provision of services, network-adequacy requirements, and star ratings mandated report: assessment of the Medicare [...]
Is CON on the Way OUT in Rural States?
The federal Rural Health Transformation Program may sound the death knell for certificate-of-need laws in some states. The rural funding program, created last year as part of H.R. 1, often referred to as the One Big Beautiful Bill Act, is a five-year, $50 billion program intended to offset some of the damage anticipated as a result of that law’s 10-year reduction in federal health care spending, and especially its Medicaid cuts, on rural health care. While every state that applied for funding through the program was awarded grants, the Centers [...]
Federal Health Policy Update for April 10
The following is the latest health policy news from the federal government for April 4-10. Some of the language used below is taken directly from government documents. Congress The House and Senate were in recess this week and are scheduled to be back in session on April 14. House Speaker Mike Johnson (R-LA) has indicated that the House will not vote on the Senate‑passed Department of Homeland Security continuing resolution until there is meaningful progress on a reconciliation package to fund U.S. Immigration and Customs Enforcement (ICE) and U.S. Customs [...]
Insurer Use of Prior Authorization Down
The insurance industry appears to be making good on its pledge to reduce its use of prior authorization for services and to make that process simpler for providers and patients Last June, some of the leading health insurers agreed to work to address prior authorization challenges. Now, an AHIP-Blue Cross Blue Shield Association survey has found that they have reduced by 11 percent the number of procedures and services that require prior authorization, which translated into 6.5 million fewer requests. Medicare Advantage plans went even further, eliminating 15 percent of [...]
Search for Undocumented Medicaid Participants Not Yielding Major Results
An administration effort to identify undocumented U.S. residents illegally enrolled in Medicaid is not turning up many undocumented residents illegally enrolled in Medicaid. At least not so far. Last fall, the administration sent the names of hundreds of thousands of suspected illegal Medicaid participants to the states and directed them to review the eligibility of those individuals. Data from five states, however, has not turned up many such individuals. Between them, Colorado and Pennsylvania reviewed 79,000 names and found none illegally enrolled in their state Medicaid programs. Texas reviewed 28,000 [...]