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Medicaid Changes on the Agenda?

With a new administration 60 days from taking office and the same party to be controlling the White House, Senate, and House of Representatives, Medicaid changes are a common topic of conversation in Washington policy circles these days. One of the objectives of those conversations: reducing federal spending on Medicaid, which in federal fiscal year 2023 amounted to $860 billion. Among the means of reducing those expenditures that can be expected to be the subject of policy deliberations in the coming months are: Instituting Medicaid work requirements. Ending the supplemental [...]

November 21, 2024|Categories: Affordable Care Act, Medicaid|Tags: Medicaid, Medicaid block grants, Medicaid eligibility, Medicaid premiums, Medicaid spending, Medicaid work requirements|

New Client

DeBrunner & Associates is pleased to welcome our newest client: Maxim Healthcare Services. Maxim’s team of nurses, behavioral health therapists, caregivers, and other clinicians help patients of all ages maintain their quality of life in the comfort of their homes. Maxim specializes in private duty nursing (PDN), also known as continuous skilled-nursing (CSN) home care, for medically-complex and vulnerable patients under Medicaid. Many patients require assistive technology such as ventilators and tracheostomies to sustain life. Maxim is a national provider of home health care services, serving clients in 39 states [...]

November 20, 2024|Categories: DeBrunner & Associates, Uncategorized|Tags: DeBrunner & Associates, Maxim Healthcare Services|

MedPAC Meets

MedPAC’s commissioners held their latest public meetings on Thursday, November 7 and Friday, November 8. The subjects on the meetings’ agenda were: reforming physician fee schedule updates and improving the accuracy of payments considering the participation bonus for clinicians in advanced alternative payment models structural differences between the prescription drug plan and Medicare Advantage prescription drug plan markets assessing Medicare Advantage provider networks Medicare’s coverage limits on stays in freestanding inpatient psychiatric facilities Go here for summaries of the issues and key points and links to the presentations delivered by [...]

November 18, 2024|Categories: Alternative payment models, hospitals, Medicare, Medicare reimbursement policy, MedPAC|Tags: Medicare, Medicare Advantage, Medicare and alternative payment models, Medicare and freestanding inpatient psychiatric facilities, Medicare APMs, Medicare Payment Advisory Commission, Medicare physician fee schedule, Medicare prescription drug plans|

Federal Health Policy Update for November 14

The following is the latest health policy news from the federal government for November 8-14. Some of the language used below is taken directly from government documents. Election Update House of Representatives Though the outcome of nine races for seats in the House remains undecided, Republicans have won enough seats to control the House in the new Congress. Yesterday, Republicans voted to nominate the current Speaker of the House, Mike Johnson (LA), for Speaker in the new Congress and will hold the vote for that position when the 119th Congress convenes [...]

November 14, 2024|Categories: ACO, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, hospitals, Medicaid, Medicaid DSH, Medicaid DSH allotments, Medicare reimbursement policy, MedPAC, Telehealth|Tags: 2024 elections, Access and Community Health Model, ACO REACH, ACO Realizing Equity, Acute Hospital at Home Program, federal hospital price transparency rule, health care cybsecurity, health insurance market concentration, Hospital-acquired infections, lame duck session of Congress, Medicaid disproportionate share, Medicaid DSH, Medicare 2025 coinsurance, Medicare 2025 deductibles, Medicare Advantage, Medicare alternative payment models, Medicare and PrEP treatment, Medicare and urban and rural differences, Medicare ICD-10, Medicare Payment Advisory Commission, Medicare physician fee schedule, Medicare prior authorization requirements, MedPAC, rural health care, telehealth flexibilities|

Federal Health Policy Update for November 7

The following is the latest health policy news from the federal government for November 1-7. Some of the language used below is taken directly from government documents. Medicare Payment Regulations Late last week CMS published four regulations describing how Medicare will pay certain providers in 2025. The following is a brief overview of those regulations. Medicare Outpatient Prospective Payment System Rate increase of 2.9 percent for outpatient and ambulatory surgical center services. New Conditions of Participation for obstetrical services. Additional payments for selected non-opioid treatments for pain relief. Minor modifications [...]

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