Centers for Medicare & Medicaid Services

Federal Health Policy Update for Wednesday, May 19

The following is the latest health policy news from the federal government as of 2:15 p.m. on Wednesday, May 19. Some of the language used below is taken directly from government documents. NASH Advocacy NASH has written to all members of Congress urging them to contact Health and Human Services Secretary Xavier Becerra about directing more of its remaining CARES Act Provider Relief Fund money to private safety-net hospitals to help them serve their diverse, predominantly low-income communities during the COVID-19 emergency. Go here to see NASH’s message to Congress. The White House COVID-19 The White House has posted a [...]

iqtsupport2021-05-19T18:01:19-04:00May 19, 2021|Centers for Medicare & Medicaid Services, Congress, Coronavirus, hospitals, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|

CMS to Hospitals: We’re Watching You

The federal government is watching to see whether hospitals are following its new rules on price transparency. And apparently, not all hospitals are. Since the first of the year the Centers for Medicare & Medicaid Services has been monitoring hospitals’ compliance with a new rule that requires public disclosure of their prices, and in April it began writing to hospitals that were not meeting the regulatory standard, telling them they have 90 days to address their shortcomings. Hospitals that fail to meet the CMS standard are subject to fines and public disclosure of their non-compliant status.Learn more from the Becker’s [...]

iqtsupport2021-05-14T06:00:00-04:00May 14, 2021|Centers for Medicare & Medicaid Services, Medicare regulations|

Federal Health Policy Update for Wednesday, May 5

The following is the latest health policy news from the federal government as of 2:45 p.m. on Wednesday, May 5. Some of the language used below is taken directly from government documents. The White House COVID-19 The White House has posted a transcript of the May 5 press briefing by its COVID-19 response team and public health officials. Department of Health and Human Services COVID-19 HHS has created a web page for its new COVID-19 Coverage Assistance Fund through which providers can be reimbursed for the cost of administering COVID-19 vaccines to the uninsured and to those whose health insurance [...]

iqtsupport2021-05-05T17:25:41-04:00May 5, 2021|Centers for Medicare & Medicaid Services, Coronavirus, COVID-19, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicare regulations, Medicare reimbursement policy, post-acute care|

CMS Reconsidering Medicare Payment Models

Five Medicare alternative payment models previously slated for implementation are being delayed, cancelled, or reconsidered. The five APMs whose futures are not clear are: The Community Health Access and Rural Transformation Model ACO Track Primary Care First Kidney Care Choices Geographic Direct Contracting Part D Payment Modernization Model Learn more about the Centers for Medicare & Medicaid Services’ latest actions on these models in the Becker’s Hospital Review article “5 CMS payment models that are under review, delayed.”

iqtsupport2021-04-26T06:00:47-04:00April 26, 2021|ACO, Alternative payment models, Centers for Medicare & Medicaid Services, Medicare, Medicare reimbursement policy|

Feds Rescind Texas Medicaid Waiver

A federal Medicaid waiver approved for the state of Texas in the waning days of the Trump administration has been rescinded by the Biden administration. The waiver called for spending as much as $100 billion for health care for low-income Texans over the next ten years. Officially, the Centers for Medicare & Medicaid Services revoked the waiver on technical grounds, maintaining that the agency “… erred in exempting the state from the normal public notice process – a critical priority for soliciting stakeholder feedback and ensuring public awareness.” The Washington Post, however, reports that according to two unnamed federal health [...]

iqtsupport2021-04-22T06:00:32-04:00April 22, 2021|Affordable Care Act, Centers for Medicare & Medicaid Services, Medicaid|

CMS Ponders Future of Medicare Payment Models

The new administration has delayed the planned launch of several new Medicare payment models and ultimately may choose not to move forward with some or to alter them. The models currently under review by the Centers for Medicare & Medicaid Services are: Primary Care First Kidney Care Choices Geographic Direct Contracting Part D Payment Modernization Model Learn more from the Becker’s Hospital Review article “CMS payment models that are under review, delayed.”

iqtsupport2021-03-30T06:00:20-04:00March 30, 2021|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare reimbursement policy|

CMS Provides Guidance on Medicaid DSH Calculations

State Medicaid program accounting for hospital uncompensated care when calculating hospital-specific Medicaid disproportionate share limits is the subject of new guidance from the Centers for Medicare & Medicaid Services. In the guidance, the Centers for Medicare & Medicaid Services explains that because of several court rulings, states can decide for themselves whether to offset third-party payer payments from costs in their Medicaid DSH calculations for periods prior to June 2, 2017 but that beginning with that date, CMS will enforce its own interpretation of the policy. In new guidance, CMS presents two methodologies for accounting for its mid-year policy change [...]

iqtsupport2020-08-29T13:00:57-04:00August 29, 2020|Centers for Medicare & Medicaid Services, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations|

Feds Delay Stark Rule, Anti-Kickback Update

An update of regulations that limit the ability of doctors to refer patients for care to sources in which those doctors have a financial interest will wait as long as another year, according to the Centers for Medicare & Medicaid Services. CMS had previously proposed regulations updating current guidelines, essentially easing them, but provider comment was so great – often, saying that the easing of the guidelines did not go far enough – that the agency decided to step back and review the situation. In a public inspection version of a notice to be published in the Federal Register, CMS [...]

iqtsupport2020-08-29T06:00:59-04:00August 29, 2020|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations|

OIG Cites Medicare, Medicaid Among Top Unimplemented Recommendations

CMS has failed to implement many of the policy changes recommended to it by HHS’s Office of the Inspector General, according to a new OIG report. Every year the Department of Health and Human Services’ OIG offers recommendations for policy changes designed to reduce fraud, waste, and abuse in HHS programs. This week, the OIG published “OIG’s Top Unimplemented Recommendations: Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs.” Among the top 25 unimplemented recommendations to the Centers for Medicare & Medicaid Services are 14 involving Medicare and Medicaid. Its top 10 unimplemented Medicare recommendations are: CMS should take [...]

iqtsupport2020-08-11T10:33:28-04:00August 11, 2020|Centers for Medicare & Medicaid Services, Medicaid, Medicare, Medicare post-acute care, Medicare reimbursement policy|

MedPAC Offers 2021 Medicare Rate Recommendations

MedPAC has recommended to Congress changes in Medicare payment rates in the coming year. In its annual report to Congress, the Medicare Payment Advisory Commission recommended the following rate changes: acute-care hospitals – a two percent rate increase and a suggestion that the difference between this two percent increase and the payment increase specified by law be used to increase the rewards hospitals may earn under Medicare’s hospital value incentive program. As a result, the value incentive program would offer a possible 0.8 percent in bonus payments, and with the recommended elimination of the 0.5 percent penalty for which hospitals [...]

iqtsupport2020-03-26T11:48:02-04:00March 26, 2020|Centers for Medicare & Medicaid Services, Medicare, Medicare reimbursement policy, MedPAC|