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Federal Health Policy Update for May 9

The following is the latest health policy news from the federal government for May 3-9. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services HHS and CMS have announced the Increasing Organ Transplant Access Model, which seeks to increase access to kidney transplants for people living with end-stage renal disease (ESRD), improve the quality of care for people seeking kidney transplants, reduce disparities among individuals undergoing the process of receiving a kidney transplant, and increase the efficiency and capability of transplant [...]

Hospitals Looking for More Skilled Nursing Options

After years of divesting skilled nursing facilities, hospitals are responding to the growing challenge of finding skilled nursing beds into which to discharge their patients by looking to get back into the skilled nursing business. Sort of. In general, acute-care hospitals are no longer interested in owning nursing homes but they are interested in securing access to the skilled nursing beds they need for their patients through bed reservation contracts, management and lease agreements, sharing their clinicians with nursing facilities, and more while also expanding their hospital at-home programs because [...]

May 9, 2024|Categories: hospitals, post-acute care|Tags: post-acute care, shortage of post-acute-care beds, shortage of skilled nursing beds, skilled nursing facilities|

Study Finds Disparities in Medicare Advantage

The quality of care Medicare Advantage participants receive varies based on their race, gender, and ethnicity according to a new report from the Centers for Medicare & Medicaid Services’ Office of Minority Health. The report, based on data from Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys and the Healthcare Effectiveness Data and Information Set (HEDIS), presents the following findings: Some disparities exist between patient experiences; most groups—except for Asian American and Native Hawaiian or other Pacific Islander (AA and NHPI) MA enrollees—showed disparities in 1 or 2 [...]

May 8, 2024|Categories: health equity, Medicare|Tags: Medicare Advantage and health care disparities, Medicare Advantage and health equity, Medicare Advantage and health inequity|

Federal Health Policy Update for May 2

The following is the latest health policy news from the federal government for April 26 – May 2. Some of the language used below is taken directly from government documents. No Surprises Act – Independent Dispute Resolution Process CMS has announced a new process for resubmitting Independent Dispute Resolution (IDR) disputes that were originally improperly batched or bundled.This new resubmission process is automated in the federal IDR portal and seeks to streamline federal IDR operations. For further information about this new process and an implementation timetable, see this CMS announcement. [...]

May 2, 2024|Categories: Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|Tags: Affordable Care Act section 1557, AHRQ News Now, CMS Medicare Promoting Interoperability Program, CMS Medicare stay of enrollment policy, COVID-19 vaccine recommendations, FDA and in vitro diagnostic products, FDA and IVDs, FDA and laboratory-developed tests, FDA and LDTs, FDA Home as a health care hub, HHS and artificial intelligence, HHS Office of Civil Rights, HHS rule affirming non-discrimination in HHS-funded grant programs and services, HHS rule prohibiting discrimination based on disability, HHS rule protecting against discrimination in health care, HHS rule protecting LTBTQ+ people, hospitals and COVID-19 data reporting, HRSA eNews, Medicare skilled nursing facility billing, MLN Connects, No Surprises Act, no surprises act independent dispute resolution|

Federal Health Policy Update for April 25

The following is the latest health policy news from the federal government for April 9-25. Some of the language used below is taken directly from government documents. Updated 340B Arbitration Process Last week HHS’s Health Resources and Services Administration (HRSA) published a regulation modifying the administrative dispute resolution (ADR) process it uses to adjudicate payment disputes between 340B-eligible providers and pharmaceutical companies. The major changes in the ADR process include the use of HRSA experts to serve on ADR panels; elimination of the $25,000 damage threshold for filing a claim; [...]

April 25, 2024|Categories: 340b, Accountable Care Organization, ACO, Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid long-term services and supports, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care, Medicaid regulations for the disabled, Medicare, Medicare post-acute care, Medicare regulations, post-acute care|Tags: 340B, 340B administrative dispute resolution, 340b ADR process, 340B arbitration process, AHRQ News Now, Change Healthcare cyberattack, CMS nursing home minimum staffing regulation, Federal Trade Commission and anti-competitive practices in health care, Federal Trade Commission and non-compete contracts, FTC and anti-competitive practices in health care, FTC and non-compete contracts, HIPAA, HIPAA and reproductive health care, HRSA eNews, Medicaid and CHIP access regulation, Medicaid and CHIP managed care access finance and quality regulation, Medicaid HCBS, Medicaid home and community based services, Medicare accountable care organizations, Medicare ACOs, MLN Connects|

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