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Federal Health Policy Update for May 22

The following is the latest health policy news from the federal government for May 16-22. Some of the language used below is taken directly from government documents. Congress: Reconciliation Early Thursday morning the House of Representatives passed its version of an FY 2025 budget reconciliation bill by a vote of 215-214. The bill underwent a number of changes during the hours before its passage and its health care provisions now include $800 billion in Medicaid cuts over the next ten years. The Congressional Budget Office projects that the bill, mostly [...]

May 23, 2025|Categories: 340b, Affordable Care Act, Centers for Medicare & Medicaid Services, COVID-19, deficit reduction, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|Tags: 340B, approved Medicaid state plan amendments, CDC and COVID vaccine recommendations, CDC and COVID vaccine review and approval, federal Medicaid matching funds, federal medical assistance percentage, FMAP, House budget reconciliation bill, Medicaid and immigration status, Medicaid disproportionate share cut delay, Medicaid DSH cut delay, Medicaid eligibility verification, Medicaid expansion population, Medicaid provider taxes, Medicaid retroactive eligibility, Medicaid state directed payments, Medicare Advantage, Medicare Advantage plan auditing, Medicare physician fee schedule rates, Mental Health Parity and Addiction Act, most favored nation prescription drug prices, proposed Medicaid cost sharing, proposed Medicaid work requirements, section 1115 Medicaid waivers, state drug importation programs|

Innovation Center to Steer New Course

The Centers for Medicare & Medicaid Services’ Center for Medicare and Medicaid Innovation has announced that it will take a new approach to developing and testing new models of health care delivery – an approach designed to be more MAHA-oriented. The Innovation Center intends to place a greater emphasis on disease and chronic condition prevention built around what it calls “three interrelated pillars:” promoting evidence-based prevention, empowering people to achieve their health goals, and driving choice and competition. The agency says it “…will focus on models that show the greatest [...]

May 19, 2025|Categories: Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare|Tags: Center for Medicare and Medicaid Innovation, Center for Medicare and Medicaid Innovation health care delivery programs, evidence-based care|

Federal Health Policy Update for May 15

The following is the latest health policy news from the federal government for May 9-15. Some of the language used below is taken directly from government documents. Congress: Reconciliation House Energy and Commerce Committee Charged with finding $880 billion in federal spending cuts over the next ten years, the House Energy and Commerce Committee this week produced legislative language to be included in a House reconciliation bill that would achieve that objective. The committee’s cost-cutting provisions include: Freezing state Medicaid provider taxes at their current level, prohibiting the establishment of [...]

May 15, 2025|Categories: Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, deficit reduction, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations, Medicare, Medicare cuts, Medicare regulations, Medicare reimbursement policy|Tags: Center for Medicare and Medicaid Innovation, federal Medicaid matching funds, federal medical assistance percentage, FMAP, FY 2025 budget reconciliation bill, House Energy and Commerce Committee, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid eligibility, Medicaid provider taxes, Medicaid state directed Medicaid payments, Medicaid state plan amendments, Medicaid work requirements, Medicare Drug Price Negotiation Program, Medicare physician payments, retroactive Medicaid eligibility, state directed Medicaid payments|

Federal Health Policy Update for May 8

The following is the latest health policy news from the federal government for May 2-8. Some of the language used below is taken directly from government documents. Congress Reconciliation Over the past several days the political gravity surrounding Medicaid cuts has begun to shift slightly. Moderate Republicans have been pushing back more forcefully and more loudly against such cuts, with some saying they will not support more than work requirements and increased enforcement checks for eligibility. Opposition to most Medicaid cuts led the Energy and Commerce Committee to delay a [...]

Supreme Court Rejects Medicare DSH Challenge

The Supreme Court has rejected the appeal of a lower court ruling that found that the Centers for Medicare & Medicaid Services did not undercalculate hospitals’ Medicare disproportionate share payments between 2006 and 2009. In the suit, more than 200 hospitals argued that the calculation of Medicare DSH payments should be based on all hospitalized patients who qualify for both Supplemental Security Income (SSI) and Medicare. The Supreme Court disagreed, confirming in a 7-2 decision the ruling of lower courts that SSI should only be included in DSH calculations when [...]

May 5, 2025|Categories: Medicare disproportionate share, Medicare DSH|Tags: Medicare disproportionate share payments, Medicare DSH, supreme court|

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