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Federal Health Policy Update for August 5

The following is the latest health policy news from the federal government for July 19 – August 5. Some of the language used below is taken directly from government documents. CMS – Medicare Payment Regulations Final FY 2025 Inpatient Prospective Payment System Regulation CMS has finalized its hospital inpatient prospective payment system rule for FY 2025. In the next fiscal year CMS will increase Medicare inpatient payments 2.9% while cutting Medicare disproportionate share hospital payments (Medicare DSH) $200 million. It also has: finalized its use of new core-based statistical area [...]

August 6, 2024|Categories: Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|Tags: AHRQ News Now, Congress and hospital and physician consolidation, Emergency Medical Treatment and Labor Act, EMTALA, FY 2025 Medicare hospice payment rates regulation, FY 2025 Medicare inpatient prospective payment system regulation, FY 2025 Medicare inpatient psychiatric facilities prospective payment system regulation, FY 2025 Medicare inpatient rehabilitation facility prospective payment system regulation, FY 2025 Medicare long-term acute-care hospital prospective payment system regulation, FY 2025 Medicare skilled nursing facility prospective payment system regulation, Health Information Technology for Economic and Clinical Health Act, HHS Office of the National Coordinator for Health Information Technology, HHS ONC proposed regulation, HHS Substance Abuses and Mental Health Services Administration, HITECH, HRSA eNews, Medicaid and language barriers to enrollment, Medicaid and prior authorization, Medicare disproportionate share, Medicare DSH, Medicare graduate medical education slots, medicare payment regulations, Medicare reimbursement regulations, MLN Connects, Provider Relief Fund reporting requirements, SAMHSA, TEAM model, TEFCA, Transforming Episode Accountability Model, Trusted Exchange Framework and Common Agreement|

Federal Health Policy Update for July 18

The following is the latest health policy news from the federal government for July 13-18. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has issued a notice alerting certain clinicians who are qualifying alternative payment model (APM) participants and who have earned an APM incentive payment that the agency does not have the current contact information it needs to disburse their payments. The notice provides information to qualified participants on how to update their Medicare billing information so that [...]

MedPAC Posts Annual Data Book

The Medicare Payment Advisory Commission has published its annual data book Health Care Spending and the Medicare Program. The book provides information on national health care and Medicare spending, Medicare beneficiary demographics, and data on dual-eligible beneficiaries, quality of care in the Medicare program, and Medicare beneficiary and other payer liabilities. MedPAC presents its data in 11 sections: national health care and Medicare spending Medicare beneficiary demographics Medicare beneficiary and other payer financial liability dual-eligible beneficiaries alternative payer models acute inpatient services – general acute-care hospitals and inpatient psychiatric hospitals [...]

July 17, 2024|Categories: Alternative payment models, Centers for Medicare & Medicaid Services, health equity, hospitals, Medicaid, Medicare, Medicare post-acute care, post-acute care, Telehealth|Tags: clinical laboratory, dual-eligible beneficiaries, Medicare Advantage, Medicare alternative payer models, Medicare and acute inpatient services, Medicare and ambulatory care, Medicare and ambulatory surgical centers, Medicare and dialysis, Medicare and general acute-care hospitals, Medicare and home health services, Medicare and hospice, Medicare and hospital outpatient services, Medicare and inpatient psychiatric hospitals, Medicare and inpatient rehabilitation facilities, Medicare and long-term care hospitals, Medicare and low-value care, Medicare and post-acute care, Medicare and prescription drugs, Medicare and skilled nursing facilities, Medicare beneficiary and other payer financial liability, Medicare beneficiary demographics, MedPAC Medicare and access-to-care survey, National health care and Medicare spending|

Federal Health Policy Update for July 12

The following is the latest health policy news from the federal government for July 6-12. Some of the language used below is taken directly from government documents. The Courts A federal court has blocked implementation of the FTC’s rule banning non-compete clauses in most employment contracts, a regulatory development with potentially significant implications for the health care industry. The temporary ban affects only the five plaintiffs in the case and it is not yet clear whether the ruling will have broader implications in the wake of the recent reversal of [...]

July 12, 2024|Categories: Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, hospitals, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|Tags: AHRQ News Now, CHIP eligibility, CMS GUIDE model, CMS Guiding an Improved Dementia Experience Model, FTC non-compete regulation, Health Data, HHS Office of the Inspector General and fraud and abuse authorities for hospitals, HT1-2, Medicaid eligibility, Medicaid regulations, Medicare and telehealth, Medicare behavioral health payments, Medicare intensive outpatient program, Medicare physician fee schedule, Medicare regulations, Medicare substance use disorder payments, MLN Connects, Office of the National Coordinator for Health Information Technology, proposed 2025 Medicare outpatient prospective payment and ambulatory surgical center payment systems regulations, proposed 2025 Medicare physician fee schedule regulation, Substance Abuse and Mental Health Services Administration women’s behavioral health services funding, Technology and Interoperability regulation|

Federal Health Policy Update for July 5

The following is the latest health policy news from the federal government for June 29-July 5. Some of the language used below is taken directly from government documents. Department of Health and Human Services Because it has found that Medicare Advantage organizations sometimes deny prior authorization requests for post-acute care after a qualifying hospital stay even though the requests met Medicare coverage rules, HHS’s Office of the Inspector General will examine selected Medicare Advantage plans’ processes for reviewing prior authorization requests for post-acute care in long-term acute-care hospitals, inpatient rehabilitation [...]

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