Bulletin Board
Bulletin Board
CMS Proposes Regulation Governing Medicare DSH
The Centers for Medicare & Medicaid Services has proposed altering its regulations governing the calculation of eligible hospitals’ Medicare disproportionate share payments (Medicare DSH). According to CMS, This proposed rule would revise our regulations on the counting of days associated with individuals eligible for certain benefits provided by section 1115 demonstrations in the Medicaid fraction of a hospital's disproportionate patient percentage. This is essentially the same change CMS included in its proposed FY 2022 and FY 2023 inpatient prospective payment system rules and then did not adopt in the final [...]
Some Surprise Billing Dispute Decisions to Resume
The Independent Dispute Resolution entities empowered by the No Surprises Act of 2020 to adjudicate disagreements between providers and payers may resume their work – but only some of it. According to the Centers for Medicare & Medicaid Services, On February 24, 2023, certified IDR entities were instructed to resume processing payment determinations on February 27, 2023, for disputes involving items or services furnished before October 25, 2022. But CMS also announced that Certified IDR entities will continue to hold issuance of payment determinations that involve items or services furnished [...]
The Emergence of “Food as Medicine”
In both the public and private sectors, a growing movement is working to integrate food as part of medical treatment – and have health care payers foot the bill. From the administration’s granting of Medicaid waivers to Arkansas, Massachusetts, and Oregon to use state and federal money to pay for food for some beneficiaries to Congress tucking $2 million into an appropriations bill for a “food is medicine pilot program” to the NIH developing a $140 million grant program that will lead to the designation of “food is medicine centers [...]
Federal Health Policy Update for February 23
The following is the latest health policy news from the federal government for February 17-23. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has issued an informational bulletin to states reiterating certain federal requirements that pertain to health care-related taxes. Recently, CMS became aware that some health care-related tax programs appear to involve agreements among providers to redistribute their Medicaid payments to hold taxpayers harmless for the cost of the tax. The bulletin reminds states that such arrangements are [...]
Most Medicaid Participants Don’t Know About Looming Eligibility Redetermination
With the COVID-19 pandemic’s continuous Medicaid eligibility set to expire in a little more than a month, nearly two-thirds of the current Medicaid population is unaware their continued participation in the program will soon be subject to review and could result in their loss of health care benefits. According to a survey conducted for the Robert Wood Johnson Foundation, “In December 2022, more than 6 in 10 adults in Medicaid-enrolled families were not aware of an upcoming return to the regular Medicaid renewal processes…” This could pose a major challenge [...]