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CMS Pulling the Plug on Continuous Medicaid Eligibility

Continuous eligibility for Medicaid is being phased out, the Centers for Medicare & Medicaid Services has announced. Characterizing its decision as one that follows more closely the statutory underpinnings of Medicaid and the Children’s Health Insurance Program, CMS explains that it “… is issuing guidance to states making clear it does not anticipate approving new or extending existing section 1115 demonstration authorities that have allowed some individuals to remain enrolled in Medicaid or CHIP for extended periods of time, even if they may not have otherwise been eligible.” At the [...]

July 24, 2025|Categories: Centers for Medicare & Medicaid Services, Medicaid|Tags: Centers for Medicare & Medicaid Services, continuous CHIP eligibility, continuous Medicaid eligibility, Medicaid section 1115 waivers, Medicaid workforce development programs|

The New Rural Health Fund

Recognizing that the Medicaid and other health care cuts in the recently enacted FY 2026 budget reconciliation bill – the so-called One Big Beautiful Bill – will exact a heavy toll on rural hospitals, Congress included in that bill a short-term Rural Health Fund designed to help ameliorate the impact of some of the cuts it was adopting. KFF Health has taken a closer look at the Rural Health Fund, how it is structured, and how it is expected to work and has identified some of the bill’s major components. [...]

July 23, 2025|Categories: Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid|Tags: FY 2026 budget reconciliation bill, Medicaid cuts, Rural Health Fund, Rural hospitals|

OBBB Implementation Timeline

DeBrunner & Associates has prepared a timeline presenting the timeline showing the stages through which the FY 2026 federal budget reconciliation bill (the “One Big Beautiful Bill”) will be implemented. Find it here.

July 21, 2025|Categories: Congress, Medicaid, Medicaid regulations, Medicare, Medicare reimbursement policy|Tags: grandfathered state directed Medicaid payments, Medicaid 30-day retroactive coverage limit, Medicaid eligibility work requirement, Medicaid expansion state cost sharing, Medicaid provider tax limit, Medicare physician fee schedule increase, moratorium on nursing home staffing requirement, Rural Health Transformation Fund|

Federal Health Policy Update for July 17

The following is the latest health policy news from the federal government for July 11-17. Some of the language used below is taken directly from government documents. Proposed Medicare Outpatient Prospective Payment and Ambulatory Surgical Center Payment System Regulation for CY 2026 CMS has published its proposed Medicare outpatient prospective payment and ambulatory surgical center payment system rule for CY 2026. Highlights include: A 2.4 percent increase in outpatient rates that is offset by a two percentage point clawback under the 340B final remedy rule, making the actual increase just [...]

July 17, 2025|Categories: 340b, Accountable Care Organization, ACO, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care, social determinants of health, Telehealth|Tags: 340B final remedy rule, Ambulatory Specialty Model, approved Medicaid state plan amendments, Cell and Gene Therapy Access Model, CY 2026 proposed Medicare outpatient prospective payment system regulation, CY 2026 proposed Medicare physician fee schedule regulation, hospital price transparency requirements, Medicare ambulatory surgical center covered procedures list, Medicare and telehealth, Medicare hospital quality star ratings, Medicare outpatient only list, Medicare outpatient rates, Medicare physician fee schedule, MedPAC data book, proposed Medicare site-neutral payments|

Hospitals Shedding OB Services

Hospitals are closing down their obstetric services at an alarming rate – especially rural hospitals. According to a recent study: In eight states, more than two-thirds of rural hospitals do not offer OB services. In 2022, the majority of rural hospitals in three states – North Dakota, Oklahoma, and West Virginia – did not offer OB services. More than 40 percent of rural hospitals ended their OB services between 2010 and 2022 in Pennsylvania, South Carolina, West Virginia, and Florida. Between 2010 and 2022, only three states – Delaware, Utah, [...]

July 14, 2025|Categories: Uncategorized|Tags: access to obstetric services, Hospitals closing obstetric services, rural hospitals closing obstetric services|

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