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Federal Health Policy Update for May 1

The following is the latest health policy news from the federal government for April 25 – May 1. Some of the language used below is taken directly from government documents. Congress Reconciliation The House and Senate returned to Washington D.C. this week and House committees have begun marking up reconciliation legislation for submission to the House Budget Committee by May 9. The Energy and Commerce Committee is expected to seek nearly $550 billion in cuts to Medicaid spending and the most likely targets for cuts continue to be work requirements [...]

May 1, 2025|Categories: Centers for Medicare & Medicaid Services, Congress, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|Tags: federal Medicaid matching rate, FMAP, funding for Medicaid expansion population, House Energy and Commerce Committee, Medicaid cuts, Medicaid provider taxes, Medicaid section 1915(c) home- and community-based services waivers, Medicaid state directed payments, Medicaid state plan amendments, Medicaid work requirements, Medicare disproportionate share payments, Medicare drug pricing negotiation program, Medicare DSH, Medicare physician payments, Medicare Prescription Drug Inflation Rebate Program, MLN Connects, telehealth, the Supreme Court and Medicare DSH|

Medicaid Financing 101

The National Association of Medicaid Directors has published a primer on how Medicaid is financed at the state and federal levels. The background paper describes the federal Medical Assistance percentage – FMAP, the rate at which the federal government provides matching funds for state Medicaid expenditures – how money flows from the federal government to the states, how Medicaid costs are budgeted at the state level, and how states raise their share of their Medicaid costs. It also outlines factors that affect Medicaid spending, such as enrollment, covered benefits, utilization, [...]

May 1, 2025|Categories: Medicaid|Tags: federal medical assistance percentage, FMAP, Medicaid budgets, Medicaid financing, Medicaid spending, Medicaid utilization|

Committee Chair Calls for 340B Changes

In a newly released report, Senate Health, Education, Labor and Pensions (HELP) Committee chair Bill Cassidy (R-LA) has pointed to problems with the 340B Drug Pricing Program and suggested ways of dealing with those problems. The report, from the committee’s majority staff, notes that … there are concerns about whether the 340B Program truly benefits low-income and uninsured patients, with some studies suggesting that the 340B benefit does not translate into increased care or lower costs for vulnerable populations. It also outlines potential changes for improving the program, including requiring [...]

April 30, 2025|Categories: 340b, Congress, Medicaid|Tags: 340B, 340B Drug Pricing Program, Senate Health Education Labor and Pensions Committee, Senate HELP Committee|

Are Medicaid Provider Taxes, State-Directed Payments in Play?

Even as the House Energy and Commerce Committee contemplates how it will reach its assigned target of $880 billion in spending cuts mostly through Medicaid cuts, the Centers for Medicare & Medicaid Services may be following a similar course by targeting two potential changes that Congress is already thought to be considering: changes in policies governing Medicaid provider taxes and state-directed Medicaid payments. Recently, CMS filed a proposed regulation titled “Preserving Medicaid Funding for Vulnerable Populations – Closing a Health Care-Related Tax Loophole” to the Office of Management and Budget [...]

April 28, 2025|Categories: Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations|Tags: Centers for Medicare & Medicaid Services, Medicaid provider taxes, Medicaid regulations, Medicaid state directed payments, Medicaid supplemental payments, Office of Management and Budget|

Federal Health Policy Update for April 24

The following is the latest health policy news from the federal government for April 18-24. Some of the language used below is taken directly from government documents. Congress The House and Senate are in recess until April 28. Upon their return to Washington D.C., committees will begin marking up reconciliation legislation for submission to their respective chambers’ budget committees by May 9. The Energy and Commerce Committee is expected to mark up its bill, with $880 billion in cuts, the week of May 5. The committee is expected to seek [...]

April 24, 2025|Categories: 340b, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicaid managed care, Medicare, Medicare reimbursement policy|Tags: 340B Drug Pricing Program, congressionally directed medical research program funding, federal Medical Assistance matching rate (FMAP), Medicaid eligibility criteria, Medicaid provider taxes, Medicaid state directed payments, Medicaid work requirements, MLN Connects|

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