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MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met last week in Washington, D.C. During the course of the deliberations, MACPAC’s staff made the following presentations to the commissioners: Automation in Medicaid Prior Authorization: Recommendations Exploring the Role of the State Medicaid Agency in the Program of All-Inclusive Care for the Elderly: Recommendations and Updated Implications Appropriate Access to Residential Services for Children and Youth with Behavioral Health Needs: Recommendations Implementing Community Engagement Requirements in Medicaid: Recommendation and Updated Implications Children and Youth with Special Health Care Needs [...]

May 13, 2026|Categories: MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid and housing, Medicaid and housing for the disabled, Medicaid regulations for the disabled|Tags: AI and Medicaid prior authorization, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid and community engagement requirements, Medicaid prior authorization, Medicaid work requirements, Program of All-Inclusive Care|

Hospital at Home Proving its Worth?

A new study suggests that hospital at home programs are producing positive results for patients and the health care system. Positive results such as greater comfort for patients, fewer returns to the hospital emergency department within 30 days of discharge, lower in-hospital mortality, reduced costs, and improved outcomes. Serving patients at home also frees hospital beds for sicker patients – an important consideration in communities where hospital occupancy levels are especially high. In hospital at home programs, patients receive acute-care services in their own homes with the help of remote [...]

May 12, 2026|Categories: hospitals, Medicare, Uncategorized|

The Latest CMS Efforts on Prior Authorization

The Centers for Medicare & Medicaid Services continues to work tackling the challenges posed by health insurers that insist they will not pay for certain medical services unless they authorize those services beforehand. In a new blog post, CMS Administrator Mehmet Oz reviews past, current, and future agency efforts to address the challenges posed by the need to obtain prior authorization for medical services. The latest such step, he notes, is adding electronic prior authorization to the Health Tech Ecosystem. Under this approach, work groups across the spectrum of stakeholders [...]

May 11, 2026|Categories: Centers for Medicare & Medicaid Services, Medicaid, Medicare|Tags: CHIP prior authorization, Health Tech Ecosystem, Medicaid prior authorization, Medicare Advantage prior authorization, prior authorization|

Federal Health Policy Update for May 7

The following is the latest health policy news from the federal government for May 1-7. Some of the language used below is taken directly from government documents. Congress Congress hopes to pass a reconciliation package to fund Immigration and Customs Enforcement (ICE) and Customs and Border Protection before June 1; lawmakers would then turn to a potential third reconciliation measure to address health care affordability before the mid-term elections. Health care provisions in a potential third reconciliation bill could include expanded access to health savings accounts (HSAs); changes to the [...]

May 7, 2026|Categories: Centers for Medicare & Medicaid Services, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|Tags: 2026 National Drug Control Strategy, CDC and measles data, FDA and HALO, FDA and Harmonizing AI and Lifecycle Operations for Data, federal budget reconciliation, Health Home Core Sets, health insurance prior authorization, Health Tech Ecosystem, IgoR program, Intelligent Generator of Research program, maternity care target areas, Medicaid state plan amendments, Medicare GLP-Bridge Program, Medicare Payment Advisory Commission, Medicare prior authorization, MedPAC, MedPAC and FY 2027 proposed hospice rule, MedPAC and FY 2027 proposed inpatient psychiatric facility rule, MedPAC and proposed FY 2027 inpatient rehabilitation facility proposed rule, MedPAC and proposed FY 2027 skilled nursing facility rule, MLN Connects, Office of National Drug Control Policy, physician visas, psychiatric over-prescribing, Senate HELP Committee hearings, USCIS and physician visa review freeze|

HHS to Attack Overprescribing of Psychiatric Drugs

The Department of Health and Human Services is launching a campaign to reduce the frequency with which providers prescribe drugs for patients with behavioral health challenges. The new campaign, announced earlier this week, will seek to analyze prescribing patterns for psychiatric drugs, evaluate those that are and are not effective, and advocate greater use of alternative, non-medication-based treatments. To support this effort, HHS plans to develop new policies and promote and support more education and outreach. HHS also has issued two sets guidelines, developed by its Substance Abuse and Mental [...]

May 7, 2026|Categories: Uncategorized|Tags: Medicaid and behavioral health care, Medicare and behavioral health care, prescribing of psychiatric drugs, psychiatric overprescribing, Substance Abuse and Mental Health Services Administration|

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