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Federal Health Policy Update for December 14

The following is the latest health policy news from the federal government for December 8-14. Some of the language used below is taken directly from government documents. MedPAC Rate Recommendations At their latest public meeting, members of the Medicare Payment Advisory Commission voted preliminary approval of the following rate updates for 2025 Medicare payments: Inpatient and outpatient services –update provided for in current law plus 1.5% and adoption of a safety-net index policy to pay safety-net hospitals another $4 billion. Physicians and other health professionals –update of 50% of the [...]

December 14, 2023|Categories: 340b, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|Tags: 340B, AI in health care, artificial intelligence in health care, Department of Health and Human Services data strategy, Department of Health and Human Services National Plan to Address Alzheimer’s disease, federal action to reduce prescription drug prices, health care worker management platform, Health Data Technology and Interoperability Certification Program Updates Algorithm Transparency and information Sharing Rule, HHS Office of the Inspector General, Home Test to Treat Program, HTI-1, Inflation Reduction Act and Medicare Part B, Inflation Reduction Act and Medicare Part D, Medicaid home and community based services, medicare advantage value-based insurance design model, Medicare inpatient prospective payment system, Medicare inpatient rehabilitation facility prospective payment system, Medicare MIPS, Medicare outpatient prospective payment system, Medicare Part B clinical laboratory fee schedule, Medicare Payment Advisory Commission, Medicare physician fee schedule, Medicare safety-net index, Medicare skilled nursing facility prospective payment system, MedPAC, MedPAC rate recommendations, merit-based incentive payment system, MLN Connects, No Surprises Act, prescription drug march-in rights, provider relief fund, state directed Medicaid payments, TEFCA, Trusted Exchange Framework and Common Agreement|

MedPAC Meets, Makes 2025 Payment Recommendations

2025 Medicare payments led the agenda at last week’s meeting of the Medicare Payment Advisory Commission. After hearing presentations on the various Medicare payment systems and discussing the adequacy of current Medicare reimbursement, MedPAC’s commissioners provisionally endorses the following changes in 2025 Medicare payments. Inpatient and outpatient services – an update provided for in current law plus 1.5 percent and a shift to a safety-net index policy that would pay safety-net hospitals another $4 billion. Physicians and other health professionals – an increase of 50 percent of the Medicare economic [...]

December 13, 2023|Categories: hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|Tags: Advisory Commission, Medicare home health prospective payment system, Medicare inpatient prospective payment system, Medicare inpatient rehabilitation prospective payment system, Medicare outpatient prospective payment system, Medicare Payment, Medicare physician fee schedule, Medicare skilled nursing facility prospective payment system, MedPAC, safety-net hospitals|

Federal Health Policy Update for December 7

The following is the latest health policy news from the federal government for December 1-7. Some of the language used below is taken directly from government documents. Congress While Congress has more than a month before the next federal funding deadline of January 19, committees are working to prepare and pass health care legislation. On the House calendar for floor votes next week is H.R. 5378, the Lower Costs, More Transparency Act. This bill would eliminate the pending cuts to Medicaid DSH for two years (those cuts are temporarily suspended [...]

Feds Tackles State Medicaid Redetermination Problems With Penalties

The Centers for Medicare & Medicaid Services has unveiled plans to penalize states that fail to comply with federal standards for redetermining the eligibility of individuals who enrolled in their Medicaid programs during the COVID-19 emergency. Under a new CMS regulation, states that fail to report on their Medicaid eligibility efforts and comply with current requirements face penalties that include civil penalties and reductions in the rate at which the federal government matches state Medicaid expenditures. According to a new interim final rule, CMS is implementing … reporting requirements and [...]

December 6, 2023|Categories: COVID-19, Medicaid|Tags: Medicaid, Medicaid eligibility redetermination, Medicaid regulations|

Medicaid Redeterminations Trigger Increase in Self-Pay Care

As states continue redetermining Medicaid eligibility for participants who were protected from disenrollment during the COVID-19 emergency, the number of patients telling providers they will pay for their own hospital, primary care, and emergency department visits has risen. The increase in self-pay has been greatest for emergency department visits, and overall, the increases occurred most often in states that began disenrolling Medicaid participants as soon as the continuous eligibility afforded by the Families First Coronavirus Response Act ended. The rise in self-pay patients suggests that many previous Medicaid participants have [...]

December 4, 2023|Categories: COVID-19, Medicaid|Tags: Medicaid continuous eligibility, Medicaid disenrollment, medicaid unwinding, self-pay patients|

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