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If ACA Funding for Medicaid Expansion Were to be Cut…

When Congress enacted the Affordable Care Act in 2010 it offered states a powerful incentive to expand their criteria for Medicaid eligibility: money to pay for most of that expansion. Under that law, the federal government pays 90 percent of the cost of providing Medicaid-covered services to individuals who became eligible for the program under the expanded criteria. So far, 41 states and the District of Columbia have taken advantage of this enhanced funding and 11 million additional people have enrolled in the Medicaid program as a result. But what [...]

March 17, 2025|Categories: Affordable Care Act, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH|Tags: Affordable Care Act, Affordable Care Act Medicaid expansion, Hospital uncompensated care, House Energy and Commerce Committee $880 billion spending cut target, Medicaid, Medicaid disproportionate share|

Federal Health Policy Update for March 13

The following is the latest health policy news from the federal government for March 7-13. Some of the language used below is taken directly from government documents. Congress Funding the Federal Government Unless Congress passes spending legislation, funding for the federal government will expire at 12:01 a.m. this Saturday, March 15. This week, the House passed a continuing resolution that would fund the federal government through the end of the 2025 federal fiscal year. The bill extends telehealth flexibilities, the Acute Hospital Care at Home program, and other health extenders [...]

March 13, 2025|Categories: Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid long-term services and supports, Medicaid regulations, Medicare, Medicare reimbursement policy, Telehealth|Tags: Affordable Care Act and DACA, Affordable Care Act and health insurance subsidies, Affordable Care Act regulation, Affordable Care Act regulation on improper enrollments, Affordable Care Act special enrollment periods, Center for Medicare and Medicaid Innovation, Center for Medicare and Medicaid Innovation Accelerated Clinical Evidence Model, Center for Medicare and Medicaid Innovation ESRD Treatment Choices model, Center for Medicare and Medicaid Innovation Integrated Care for Kids Model, Center for Medicare and Medicaid Innovation Making Care Primary Model, Center for Medicare and Medicaid Innovation Maryland Total Cost of Care model, Center for Medicare and Medicaid Innovation Medicare $2 Drug List Model, Center for Medicare and Medicaid Innovation Primary Care First model, Department of Health and Human Services Office for Civil Rights, Department of Health and Human Services Office of the General Counsel, Department of Health and Human Services’ Office of the Inspector General, FY 2025 budget, FY 2025 budget reconciliation, FY 2025 continuing resolution, hospital price transparency, MACPAC, MACPAC annual report to Congress, Medicaid and CHIP Payment and Access Commission, Medicaid and CHIP state plan amendment approvals, Medicaid improper payments, medicare improper payments, Medicare Payment Advisory Commission, MedPAC, MedPAC annual report to Congress, MLN Connects|

MedPAC Meets

MedPAC’s commissioners held their latest public meetings on Thursday, March 6 and Friday, March 7. The subjects on the meetings’ agenda were: reforming Medicare physician fee schedule updates and improving the accuracy of relative payment rates reducing beneficiary cost-sharing for Medicare-covered outpatient services at critical access hospitals Medicare insurance agents Medigap mandated report: payment for ground ambulance services examining home health care use among Medicare Advantage enrollees institutional special needs plans reducing beneficiary cost-sharing for Medicare-covered outpatient services at critical access hospitals Go here for summaries of the issues and key points [...]

March 12, 2025|Categories: Medicare, Medicare reimbursement policy, MedPAC|Tags: Medicare Advantage and home health services, Medicare and ambulance services, Medicare and critical access hospitals, Medicare and institutional special needs, Medicare Payment Advisory Commission, Medicare physician fee schedule, Medigap, MedPAC|

Federal Health Policy Update for March 6

The following is the latest health policy news from the federal government for March February 28 – March 6. Some of the language used below is taken directly from government documents. Congress The current continuing resolution funding the federal government expires on March 14. Leaders intend to propose a long-term continuing resolution through the end of the current federal fiscal year in September. The likelihood of success of that approach is uncertain. Separately, a number of health care extenders, including preventing cuts to Medicaid disproportionate share (Medicaid DSH), an extension [...]

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met publicly last week in Washington, D.C. The following is MACPAC’s own summary of its meeting. During MACPAC’s February 2025 meeting, staff presented four draft policy recommendations to address challenges related to transitions from pediatric to adult care for children and youth with special health care needs (CYSHCN). The draft recommendations reflect the Commission’s feedback from the December and January meetings. The recommendations include requiring states to develop a strategy for transitions of care for CYSHCN, which includes developing an [...]

March 5, 2025|Categories: MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid regulations|Tags: Medicaid and behavioral health care, Medicaid and prior authorization, Medicaid directed payments, Medicaid supplemental payments|

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