Affordable Care Act

Federal Health Policy Update for July 13

The following is the latest health policy news from the federal government for June 30 – July 13. Some of the language used below is taken directly from government documents. 340B CMS has published a proposed regulation outlining how it plans to reimburse hospitals for reductions in 340B prescription drug payments that it implemented from 2018 to 2022 but that a federal court found to be illegal. The agency calculates that it owes participating 340B providers $9 billion, which it proposes paying to those providers in single lump-sum payments. CMS also proposes offsetting these payments through reductions in future non-drug [...]

iqtsupport2023-07-13T15:50:46-04:00July 13, 2023|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for June 29

The following is the latest health policy news from the federal government for June 23-29. Some of the language used below is taken directly from government documents. The White House President Biden has issued an executive order on strengthening access to affordable contraception and family planning services for women with private health insurance and through Medicaid, Medicare, and federally supported health programs and to foster research on access. Learn more from this White House fact sheet and the administration’s executive order. Department of Health and Human Services HHS’s Office of the Inspector General (OIG) has posted its final rule [...]

iqtsupport2023-06-29T15:36:39-04:00June 29, 2023|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare reimbursement policy|

Federal Health Policy Update for April 20

The following is the latest health policy news from the federal government for April 8 – 20. Some of the language used below is taken directly from government documents. The White House The Biden administration has announced a plan to expand health coverage for Deferred Action for Childhood Arrivals (DACA) individuals. To this end, it announced that HHS will soon propose a rule amending the definition of “lawful presence,” for purposes of Medicaid and Affordable Care Act coverage, to include DACA recipients. If finalized, the rule would make DACA individuals eligible for these programs for the first time. Under the proposed rule, [...]

iqtsupport2023-04-20T17:24:28-04:00April 20, 2023|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

Federal Health Policy Update for December 22

The following is the latest health policy news from the federal government for the week of December 19-22. Some of the language used below is taken directly from government documents. Congress As of this writing, Congress continues to work on an FY 2023 omnibus spending bill: the Senate has passed it but the House has not yet addressed it. Highlights of what negotiators have agreed to – but that have not yet been adopted – include: Preventing the additional four percent Medicare sequester for two years. Reducing by more than half the 4.5 percent cut in Medicare payments to physicians [...]

iqtsupport2022-12-22T17:30:38-05:00December 22, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, hospitals, Medicaid, Medicare, Medicare bad debt reimbursement, Medicare regulations, Medicare reimbursement policy, Telehealth|

FEDERAL HEALTH POLICY UPDATE FOR December 1

The following is the latest health policy news from the federal government for the week of November 28 to December 1. Some of the language used below is taken directly from government documents. 340B HHS and its Health Resources and Services Administration (HRSA) have proposed revising the current 340B administrative dispute resolution process. Since the current process was introduced in 2020 HRSA has encountered policy and operational challenges with its implementation and now proposes revising it and is soliciting comment on its proposed new approach. Changes include changing the nature of the dispute resolution process, using different kinds of professionals [...]

Health Insurance Markets Remain Highly Concentrated

The health insurance market was highly concentrated in 42 of the 50 states in 2019 and 2020 – the continuation of a trend identified in 2010 that has persisted ever since, according to a new report by the U.S. Government Accountability Office. The GAO considers a market concentrated if three or fewer insurers in a state have 80 percent of that market. Using Centers for Medicare & Medicaid Services health insurance enrollment data, the GAO looked at three distinct aspects of markets – individual policies, small group policies, and large group coverage – and found that Each of the three [...]

iqtsupport2022-11-10T06:00:51-05:00November 10, 2022|Affordable Care Act, Uncategorized|

Federal Health Policy Update for Monday, August 8`

The following is the latest health policy news from the federal government as of 2:30 p.m. on Monday, August 8. Some of the language used below is taken directly from government documents. Congress On Sunday, the Senate passed the Democrats’ health care, climate, and tax bill, H.R. 5376, The Inflation Reduction Act, by a vote of 51-50, with Vice President Harris casting the tie-breaking vote. Health care provisions in the reconciliation bill include: allowing Medicare to negotiate prescription drug prices limiting out-of-pocket prescription drug costs for Medicare enrollees to $2,000 a year extending for three years enhanced Affordable Care Act [...]

iqtsupport2022-08-08T16:12:06-04:00August 8, 2022|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, COVID-19, deficit reduction, Medicaid, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for Tuesday, August 2

The following is the latest health policy news from the federal government as of 2:45 p.m. on Tuesday, August 2. Some of the language used below is taken directly from government documents. White House The White House has announced two new actions to address the youth mental health crisis: it will award nearly $300 million from the FY 2022 bipartisan omnibus agreement to expand access to mental health services in schools and it will encourage governors to invest more in school-based mental health services. Learn more about this effort, including the individual funding components of the $300 million in new [...]

iqtsupport2022-08-02T16:39:35-04:00August 2, 2022|Affordable Care Act, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, post-acute care|

Transparency Comes to Health Insurer Payments

When the calendar turned to July, health insurers came under a new federal requirement that they post on web sites the price they pay to every provider with which they contract for every service they cover. The mandate, which traces its origins to the Affordable Care Act and was introduced in a 2019 executive order, was designed to enable consumers to compare what different insurers pay different providers for different services and possibly help them shop for more affordable services for themselves. Doing so, however, will be a challenge for consumers at least at first because insurers will be posting [...]

iqtsupport2022-07-06T13:42:45-04:00July 6, 2022|Affordable Care Act, hospitals|

Federal Health Policy Update for Thursday, April 7

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, April 7. Some of the language used below is taken directly from government documents. White House The administration is proposing to address a flaw in the Affordable Care Act often referred to as the “family glitch.” Under the ACA, people who do not have access to “affordable” health insurance through their jobs may qualify for a premium tax credit to purchase coverage on the ACA’s health insurance marketplaces. Current regulations define employer-based health insurance as “affordable” if the coverage for the employee [...]

iqtsupport2022-04-07T17:12:01-04:00April 7, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|