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Hospitals Sue Over Medicare DSH Payments

Fifteen years ago, a federal court ruled that the Centers for Medicare & Medicaid Services was calculating Medicare disproportionate share payments (Medicare DSH) incorrectly and ordered the agency to fix the problem and reimburse eligible hospitals for the underpayments they had experienced. Now, after 15 years of waiting, 40 of those hospitals are suing for their money. In a suit filed in federal court, the hospitals outline the actions CMS has and has not taken to correct the problem and write that The agency's contractors have not performed the revised [...]

March 21, 2023|Categories: Centers for Medicare & Medicaid Services, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy|Tags: Medicare disproportionate share, Medicare DSH|

Federal Health Policy Update for March 16

The following is the latest health policy news from the federal government for March 13-16. Some of the language used below is taken directly from government documents. Medicare Payment Advisory Commission (MedPAC) MedPAC has published its “March 2023 Report to the Congress: Medicare Payment Policy.” In this year’s report MedPAC considers the context of the Medicare program, including the near-term consequences of COVID-19 and the longer-term effects of program spending on the federal budget and the program’s financial sustainability. It evaluates payment adequacy and make recommendations concerning Medicare payment policy [...]

March 16, 2023|Categories: Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|Tags: COVID-19, COVID-19 public health emergency, COVID-19 vaccines, Inflation Reduction Act, MACPAC, MACPAC March 2023 report to Congress, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicare disproportionate share, Medicare Drug Price Negotiating Program, Medicare DSH, Medicare Payment Advisory Commission, Medicare Prescription Drug Inflation Rebate Program, MedPAC, MedPAC March 2023 report to Congress, MedPAC Medicare rate recommendations, MIPS, MLN Connects, provider relief fund|

Federal Health Policy Update for Friday, March 10

The following is the latest health policy news from the federal government for March 6-10. Some of the language used below is taken directly from government documents. White House FY 2024 Budget Proposal The Biden administration this week released its proposed FY 2024 federal budget. Among its many proposals are measures to extend the life of the Medicare hospital trust fund and reduce Medicare beneficiaries’ health care costs; to reduce prescription drug costs for consumers, Medicare, and Medicaid; to return high Medicaid managed care organization profits to the federal government; [...]

March 10, 2023|Categories: 340b, Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|Tags: 340B, Biden FY 2024 proposed budget, continuous Medicaid eligibility, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, medicaid unwinding, Medicare Advantage, Medicare Bundled Payments for Care Improvement Advanced Model, Medicare Payment Advisory Committee, Medicare post-acute care prospective payment system, MedPAC, MLN Connects|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The March 2023 MACPAC meeting began with a staff presentation on potential recommendations for countercyclical disproportionate share hospital (DSH) allotments. Medicaid DSH payments offset hospital uncompensated care costs for Medicaid-enrolled and uninsured patients. During economic recessions, Medicaid enrollment and the number of people who are uninsured increases. During the October 2022 MACPAC meeting, Commissioners agreed that a countercyclical policy should be implemented during future [...]

March 10, 2023|Categories: MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations for long-term care|Tags: Medicaid disproportionate share, Medicaid DSH, Medicaid full-risk capitation, Medicaid managed care, medicaid unwinding, Medicare-Medicaid dual eligibles|

MedPAC Meets

The government agency that advises Congress on Medicare payment matters met publicly in Washington, D.C. last week. During the virtual meeting, members of the Medicare Payment Advisory Commission discussed: reforming Medicare’s wage index system addressing the high prices of drugs covered under Medicare Part B a prototype design for a post-acute care prospective payment system favorable selection and future directions for Medicare Advantage payment policy aligning fee-for-service payment rates across ambulatory care settings MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are [...]

March 9, 2023|Categories: Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, post-acute care|Tags: Medicare Advantage, Medicare area wage index, Medicare Payment Advisory Commission, Medicare post-acute care prospective payment system, Medicare post-acute-care payments, MedPAC|

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