CMS updates COVID-19 guidelines, regulations, the waiving of regulations, and more daily on the “Current Emergencies” page of the CMS website. Find it here. In addition, the Centers for Disease Control and Prevention (CDC) regularly posts COVIS-19 updates of its own. Find them here.
State Medicaid agencies and CHIP programs have received new guidance on the federal resources available to them to fight the COVID-19 national health emergency through a new FAQ published by the Centers for Medicare & Medicaid Services last week. Among the issues addressed in the FAQ are eligibility, enrollment, benefits, cost sharing, workforce issues, telehealth, and more. Health care providers may find this information useful when serving their patients. See CMS’s news release describing the FAQ here and the FAQ itself here.
Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s March agenda were: Addressing Medicare Shared Savings Program vulnerabilities The role of specialists in alternative payment models and accountable care organizations Realigning incentives in Medicare Part D Redesigning the Medicare Advantage quality bonus program Mandated report: Impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees Improving Medicare’s end-stage renal disease prospective payment system Separately payable drugs in the hospital outpatient prospective payment system MedPAC is an independent congressional agency that advises [...]
Health care accrediting organizations will be the subject of scrutiny and possible action by the federal government in the coming months. At a recent conference, Centers for Medicare & Medicaid Services administrator Seem Verma said that Receiving CMS’s authorization to inspect and deem healthcare providers compliant with Medicare’s quality standards is nothing short of assuming a sacred public trust…But an increasing amount of evidence indicates that accrediting organizations are not living up to that high bar. According to Verma, CMS’s interest is motivated by a number of recent incidents of “serious deficiencies” among hospitals that had been found compliant with [...]
For the second time in four months, the federal government has announced its intention to collect data from hospitals and other providers on what they pay for the prescription drugs they purchase through the section 340B prescription drug discount program. Last week the Centers for Medicare & Medicaid Services published a notice announcing its intention to collect this data. Previously, health care interests sued CMS when it attempted in 2018 to reduce payments to providers for drugs purchased through the 340B program and the court ruled against CMS, maintaining that the agency did not have enough data on hospitals’ acquisition [...]
Last week the Trump administration unveiled its Healthy Adult Opportunity program, a new, optional, already-controversial approach to structuring state Medicaid programs. Ever since, the program – essentially, Medicaid block grants – has been the subject of criticism from many public officials and health care stakeholders. Now, Centers for Medicare & Medicaid Services administrator Seema Verma, who oversaw the development of Healthy Adult Opportunity, has responded to the program’s critics in an op-ed piece published in the Washington Post. See her commentary “No, the Trump administration is not cutting Medicaid.”
The administration’s proposed Medicaid fiscal accountability regulation and its guidance encouraging states to implement Medicaid block grants have incurred widespread opposition among a variety of health care groups. The Medicaid fiscal accountability regulation would, if adopted, impose new restrictions on how states raise their share of their Medicaid spending, potentially limiting state participation in Medicaid or necessitating tax increases to fill the funding gap if long-accepted financing tools are no longer available to them. The Medicaid block grant guidance offers states a blueprint for curtailing their Medicaid costs by imposing limits on that spending that they negotiate with the federal [...]
In late December, PBS broadcast an interview with Centers for Medicare & Medicaid Services administrator Seema Verma. Kaiser Health News has published a transcript of excerpts from that interview during which Verma discusses Medicaid – including enrollment, eligibility, services, and children – Medicare for all, administration attempts to reduce health care costs, protection for people with pre-existing conditions, and more. Read those excerpts in the Kaiser Health News article “One-On-One With Trump’s Medicare And Medicaid Chief: Seema Verma."
A federal court has provided relief to hospitals that saw reduced Medicare payments for some outpatient services in 2019. But that relief is only partial. In response to a suit filed by several hospital groups, a federal court ruled that the Centers for Medicare & Medicaid services had illegally reduced Medicare payments for services provided in some hospital off-campus outpatient departments beginning on January 1, 2019 and ordered the federal government to repay the hospitals for the Medicare revenue they lost. The reduced payments were part of a new Medicare site-neutral payment policy for outpatient services, and CMS has announced [...]
President Trump and Vice President Pence have stepped into a feud between Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services administrator Seema Verma. Azar and Verma have apparently clashed on numerous occasions in recent months, with Verma criticizing at least one Azar proposal during an Oval Office meeting and Azar being overruled by the president on several occasions. According to Politico, President Trump “…instructed Azar to smooth things over.” Verma, meanwhile, met with Vice President Pence, with whom she worked when Pence was governor of Indiana. As head of CMS, Verma oversees the country’s [...]