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Coming Soon: The Rural Health Transformation Program

Federal health care officials are getting ready to bring the FY 2025 budget reconciliation bill’s “Rural Health Transformation Program” to life. Added to the “One Big Beautiful Bill” to provide assistance to rural hospitals that maintained that their existence would be jeopardized by the Medicaid cuts and other health care changes in the law, the Rural Health Transformation Fund will consist of $50 billion to be distributed to rural health care organizations over a five-year period. Half of that money will go to states that successfully apply it – the [...]

August 11, 2025|Categories: hospitals, Medicaid|Tags: Rural Health Transformation Program|

Federal Health Policy Update for August 7

The following is the latest health policy news from the federal government for August 2-7. Some of the language used below is taken directly from government documents. Congress The House and Senate are both in recess. When Congress returns in September its top priority will be funding the federal government before the fiscal year ends on September 30, likely requiring a continuing resolution to avoid a shutdown. Several major health care programs and extenders are set to expire at the end of the fiscal year, including Medicaid disproportionate share (Medicaid [...]

August 7, 2025|Categories: 340b, Congress, COVID-19, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare reimbursement policy, Telehealth|Tags: 340B, 340B Rebate Model Pilot Program, Acute Hospital Care at Home, approved Medicaid state plan amendments, CDC and opioid labeling requirements, CDC and opioid prescribing directions, Connecting Kids to Coverage Outreach and Enrollment Cooperative Agreement, FY 2026 Medicare hospice rates, FY 2026 Medicare inpatient prospective payment system and long-term care hospital prospective payment system, FY 2026 Medicare inpatient psychiatric facility prospective payment system, FY 2026 Medicare inpatient psychiatric facility rates, FY 2026 Medicare inpatient rates, FY 2026 Medicare inpatient rehabilitation facility prospective payment system, FY 2026 Medicare inpatient rehabilitation facility rates, FY 2026 Medicare long-term hospital rates, FY 2026 Medicare skilled nursing facility prospective payment system, FY 2026 Medicare skilled nursing facility rates, GAO COVID-19 report, Justice Department DEI memo, Justice Department memo on unlawful discrimination, Medicaid disproportionate share, Medicaid DSH, Medicare Payment Advisory Commission, Medicare site-neutral payments for hospitals, MedPAC, MLN Connects, mRNA vaccines, new MedPAC commissioners, Pharmaceutical companies most favored nation prices, rescinded COVID-19 waivers, telehealth|

The Coming Medicaid Work Requirement

Among the many Medicaid-related aspects of the recently enacted FY 2026 budget reconciliation bill – the One Big Beautiful Bill Act – is a new requirement that much of the Medicaid population be employed or participate in some acceptable form of “community engagement.” But how will the work requirement work? How will it be implemented and enforced? KFF has taken an in-depth look at this matter, reporting on such issues as: What the new law requires. The timeline for the work requirement’s implementation. How much money the states and the [...]

August 6, 2025|Categories: Congress, Medicaid|Tags: FY 2026 budget reconciliation bill, Medicaid cuts, Medicaid eligibility, Medicaid work requirement, One Big Beautiful Bill Act|

Federal Health Policy Update for July 31

The following is the latest health policy news from the federal government for July 25-31. Some of the language used below is taken directly from government documents. Congress The House recessed last week and the Senate is still in session. When Congress returns in September its top priority will be funding the federal government before the fiscal year ends on September 30, likely requiring a continuing resolution to avoid a shutdown. Several major health care programs and extenders are set to expire at the end of the fiscal year, including [...]

July 31, 2025|Categories: 340b, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare reimbursement policy, Telehealth|Tags: 2024 National Survey on Drug Use and Health, 340B prescription drug program, approved Medicaid state plan amendments, HealthData.gov update, Hepatitis C pilot program, Living HHS Open Data Plan, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicare Acute Care at Home, Medicare dependent hospital program, Medicare low-volume hospital program, Medicare site-neutral payments for hospitals, next-generation digital health ecosystem, No Surprises Act, No Surprises Act independent dispute resolution process, patient harm events, Scientific Registry of Transplant Recipients, telehealth|

Providers Dominating No Surprise Act Dispute Resolution

Health care providers are winning the vast majority of payment disputes resolved under the No Surprises Act’s Independent Dispute Resolution process. Contrary to the expectation that the number of cases the process would adjudicate would decline once payers and providers got a better sense of what kinds of cases were being disputed and their outcome, the number of cases going into the process has only grown – considerably. And so has providers’ success rates. Providers won 70 percent of the disputes during the first quarter of 2023 and that rate [...]

July 30, 2025|Categories: Uncategorized|Tags: independent dispute resolution, No Surprises Act|

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