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Federal Health Policy Update for August 8

The following is the latest health policy news from the federal government for August 3-8. Some of the language used below is taken directly from government documents. No Surprises Act A federal appeals court has upheld a February lower court ruling that found that the current No Surprises Act’s arbitration process for addressing payment disagreements between payers and providers favored payers by giving too much weight to “qualifying payment amounts,” which are the median of what insurers contract to pay providers in a given geographic area. Learn more from the [...]

Number of Uninsured on the Rise

The number of uninsured Americans has risen significantly over the past year: from 25 million in March of 2023 to 27 million in March of 2024, according to new data from the Centers for Disease Control and Prevention (CDC), with the uninsured rate rising from a record low of 7.7 percent to 8.2 percent. The rise in the number of uninsured people results primarily from individuals who became eligible for Medicaid during the COVID-19 public health emergency, a period during which states could not redetermine eligibility without losing some of [...]

August 7, 2024|Categories: Affordable Care Act, Medicaid|Tags: Affordable Care Act health insurance subsidies, health exchanges, medicaid unwinding, uninsured rate|

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|

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