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

Bulletin Board

Bulletin Board

Federal Health Policy Update for July 9

Don’t Miss: CMS ends fast track process for Medicaid 1115 waiver renewals HHS publishes 2026 regulatory agenda HHS asks hospitals to sign healthy foods pledge The following is the latest health policy news from the federal government for July 3-9.  Some of the language used below is taken directly from government documents. Congress Congress will return to session on July 13.  Committees with jurisdiction over health care will continue focusing on legislation that could ultimately be incorporated into a reconciliation package, FY 2027 appropriations legislation, or other end-of-year legislation. Centers [...]

Where is ACA Enrollment Falling the Most?

While the decline in Affordable Care Act enrollment in 2026 is getting a great deal of attention – enrollment is down 13 percent or three million in 2026 – are there some places where enrollment is falling more than in others? Yes.  In Oklahoma and Ohio, ACA plan enrollment has fallen by nearly a third. Enrollment also is down significantly in Arizona, Indiana, Louisiana, Michigan, Minnesota, Mississippi, and South Carolina. The enrollment declines are generally attributed to the loss of enhanced premium tax credits that were eliminated in H.R. 1, [...]

Administration, Congress, Press Hospitals for Reforms

Even at a time when passing major health care legislation in the near future becomes increasingly unlikely, the hospital community continues to face serious challenges from both the administration and Congress. The Centers for Medicare & Medicaid Services has proposed making more Medicare outpatient payments on a site-neutral basis and reducing Medicare payments to hospitals for prescription drugs covered by the 340B drug pricing program. It also threatens other changes in the 340B program that hospitals believe will make it more difficult – and costly – to participate in. Meanwhile, [...]

Proposed Limits on Medicaid State-Directed Payments Explained

In late May, the Centers for Medicare & Medicaid Services proposed new restraints on state-directed Medicaid payments.  In so doing, CMS was seeking to implement a mandate included in H.R. 1, last year’s federal budget reconciliation bill. Since 2016, states have been requiring Medicaid managed care plans to supplement their regular payments to selected Medicaid providers, especially hospitals, as a means of ensuring access to certain medical services in communities where such services are otherwise scarce.  States, in turn, have been drawing down federal Medicaid matching funds for those additional [...]

Proposed Medicare Rule Could Hit Hospitals Hard

The Centers for Medicare & Medicaid Services’ proposed 2027 Medicare outpatient prospective payment system rule could pose several serious challenges to hospitals. Among them: A proposed increase of 2.4 percent in payments for outpatient services that could be reduced to only 0.6 percent if CMS adopts its proposal to accelerate its clawback from previous 340B litigation to a three percent reduction. The transition of still more imaging services to site-neutral payments and a prohibition against Medicare outpatient payments for off-campus hospital-based outpatient departments unless each department has its own National [...]

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