ACO

Medicare ACO Participation Rising

Participation in Medicare’s various accountable care organizations is increasing, the Centers for Medicare & Medicaid Services reports. According to CMS, 50 new ACOs will participate in its Medicare Shared Savings Program in 2024 along with another 19 that will participate in a new, permanent payment option version of that program.  Another 71 ACOs renewed their participation in the program, bringing the total number of ACOs in the program to 480 that together will serve nearly 11 million traditional Medicare beneficiaries. Other Medicare ACOs account for another three million participants.  Among them are 2.6 million served by 122 ACOs in the [...]

Federal Health Policy Update for January 4

The following is the latest health policy news from the federal government for December 21 to January 4.  Some of the language used below is taken directly from government documents. No Surprises Act HHS, the departments of Labor and the Treasury, and the Office of Personnel Management intend to reopen the comment period for submitting comments on a proposed rule governing federal Independent Dispute Resolution (IDR) operations.  They plan to publish a notice to this effect in the near future with further details on reopening the comment period. Department of Health and Human Services HHS’s Office of the National Coordinator [...]

Federal Health Policy Update for December 20

The following is the latest health policy news from the federal government December 14-20.  Some of the language used below is taken directly from government documents. Congress The House is in recess until January 9.  The Senate has delayed its recess to continue negotiations on a possible foreign aid and border policy deal. Democrats from the House Ways and Means Committee have published a report on the relationship between the U.S. health care system and climate change.  View their report “Health Care and the Climate Crisis:  Preparing America’s Health Care Infrastructure.” No Surprises Act The federal government has reopened the [...]

Federal Health Policy Update for December 14

The following is the latest health policy news from the federal government for December 8-14.  Some of the language used below is taken directly from government documents. MedPAC Rate Recommendations At their latest public meeting, members of the Medicare Payment Advisory Commission voted preliminary approval of the following rate updates for 2025 Medicare payments: Inpatient and outpatient services –update provided for in current law plus 1.5% and adoption of a safety-net index policy to pay safety-net hospitals another $4 billion. Physicians and other health professionals –update of 50% of the Medicare economic index and a new add-on payment for services [...]

Federal Health Policy Update for August 24

The following is the latest health policy news from the federal government for August 11-24.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services After suspending the No Surprises Act-created Independent Dispute Resolution process in the wake of a court ruling striking down a recent increase in fees for that process, CMS has established a new rate structure for initiating the adjudication of payment disagreements between providers and payers.  It explains the new rate structure in this new FAQ, which nevertheless notes that despite the creation of new rates, the Independent [...]

Federal Health Policy Update for Friday, March 10

The following is the latest health policy news from the federal government for March 6-10.  Some of the language used below is taken directly from government documents. White House FY 2024 Budget Proposal The Biden administration this week released its proposed FY 2024 federal budget.  Among its many proposals are measures to extend the life of the Medicare hospital trust fund and reduce Medicare beneficiaries’ health care costs; to reduce prescription drug costs for consumers, Medicare, and Medicaid; to return high Medicaid managed care organization profits to the federal government; to make behavioral health care more affordable for seniors; to [...]

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 prohibited.  Find the CMS bulletin here. CMS has posted a [...]

Federal Health Policy Update for Friday, April 1

The following is the latest health policy news from the federal government as of 2:30 p.m. on Friday, April 1.  Some of the language used below is taken directly from government documents. Provider Relief Fund After April 5, this program also will stop accepting claims for administering vaccines to uninsured individuals.  See this notice for further information about both deadlines for submitting claims. Proposed Medicare Payment Regulations for FY 2023 CMS has published its proposed inpatient rehabilitation facility (IRF) prospective payment system and IRF quality reporting program for FY 2023.  The agency proposes a 2.8 percent net increase in Medicare [...]

Federal Health Policy Update for Wednesday, March 30

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, March 30.  Some of the language used below is taken directly from government documents. Provider Relief Fund The Provider Relief Fund last week distributed more than $413 million to more than 3600 providers across the country, the fourth round of Phase 4 payments since those payments began last November.  This is in addition to nearly $7.5 billion in American Rescue Plan (ARP) Rural payments over the past four months.  HHS’s Health Resources and Services Administration (HRSA), which administers the Provider Relief Fund, [...]

Federal Health Policy Update for Tuesday, March 22

The following is the latest health policy news from the federal government as of 2:30 p.m. on Tuesday, March 22.  Some of the language used below is taken directly from government documents. Provider Relief Fund As of March 22 at 11:59 p.m. (eastern) the HRSA (Health Resources and Services Administration) COVID-19 Uninsured Program will stop accepting claims for testing and treatment due to lack of funds and on April 5 at 11:59 p.m. (eastern) the HRSA COVID-19 Uninsured Program and COVID-19 Coverage Assistance Fund will stop accepting vaccination claims due to a lack of funds.  HRSA has released additional information [...]

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