Bulletin Board
Bulletin Board
States Introduce Changes on Medicaid Unwinding
With more than five million people already dropped from state Medicaid rolls and the federal government telling them they are not doing a good job, some states are introducing changes in how they review the eligibility of their Medicaid population as part of the Medicaid unwinding process. With the end of the formal public health emergency and continuous Medicaid eligibility, states have begun the significant challenge of reviewing the eligibility of all of their Medicaid participants. Last month the Centers for Medicare & Medicaid Services sent letters to all 50 [...]
No Surprises Act’s Dispute Resolution Suspended
When a federal court in Texas rejected an increase in the fee for providers to initiate payment challenges under the No Surprises Act’s Independent Dispute Resolution process, the Centers for Medicare & Medicaid Services quickly suspended use of that process while it reviewed the court ruling – suspended both the adjudication of current complaints and the filing of new ones. Almost as quickly, CMS announced that it would reduce the fee required to initiate payment disputes between providers and payers under the 2020 law that sought to prevent surprise medical [...]
Hospitals Continue to Protest Medicare DSH Cut
The regulation has already been finalized but hospitals continue to protest Medicare’s intention to reduce their Medicare disproportionate share (Medicare DSH) uncompensated care payments. The cut, proposed at $115 million in April, when the Centers for Medicare & Medicaid Services proposed it, ended up just shy of $1 billion in the final regulation. The major change, according to CMS, comes because the agency’s actuaries have projected a lower uninsured rate than when CMS proposed the $115 million cut in the spring. Medicare DSH payments are intended to help hospitals that [...]
Feds Pointing Fingers on Medicaid Unwinding Shortcomings
After months of vague, general assertions about shortcomings in states’ efforts to redetermine the eligibility of their Medicaid participants as part of the post-pandemic continuous Medicaid unwinding process, the federal government is now revealing which states are having problems – and what those problems are. In public letters to the 50 states, the Centers for Medicare & Medicaid Services cites three major shortcomings in states’ efforts: paperwork problems, long call center waiting times, and the slow processing of applications. According to the letters, 36 states are falling short on at [...]
Federal Health Policy Update for August 10
The following is the latest health policy news from the federal government for August 4-10. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has temporarily suspended the federal Independent Dispute Resolution process, which adjudicates problems involving surprise medical bills, in the wake of a federal court ruling that found some of the process’s underlying regulations invalid. CMS has directed the certified Independent Dispute Resolution entities to pause all dispute resolution activities. As a result, providers and insurers temporarily cannot [...]