Centers for Medicare & Medicaid Services

Federal Health Policy Update for June 6

The following is the latest health policy news from the federal government for May 31-June 6. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services The deadline for stakeholders to submit comments on CMS’s proposed FY 2025 Medicare inpatient prospective payment system and long-term-care hospital prospective payment system regulation is Monday, June 10. Go here for further information about the proposed rule and how to submit comments. CMS has posted a bulletin describing billing changes in the Medicare hospital outpatient prospective payment system that will take effect on July 1. Find [...]

joe2024-06-06T20:37:05-04:00June 6, 2024|Accountable Care Organization, ACO, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for May 30

The following is the latest health policy news from the federal government for May 24-30. Some of the language used below is taken directly from government documents. Congress When the House and Senate return to Washington, DC from the Memorial Day recess next week committees will resume holding hearings and markups on health care policy while appropriators will focus on funding for federal fiscal year 2025, which begins October 1. While there seems to be plenty of activity in Congress it is widely expected that only the most essential bills, like emergency supplemental packages and bills to keep the federal [...]

joe2024-05-30T21:29:22-04:00May 30, 2024|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, hospitals, Medicaid, Medicaid managed care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for May 23

The following is the latest health policy news from the federal government for May 18-23. Some of the language used below is taken directly from government documents. Congress Leaders of the Senate Finance Committee have released a white paper outlining potential reforms of how Medicare pays physicians and how Medicare might better meet the needs of those with chronic illnesses. The white paper notes areas of interest the committee sees as opportunities for reform, including: Creating sustainable payment updates to ensure clinicians can own and operate their practices. Creating incentives for alternative payment models that reward providing better care at [...]

joe2024-05-23T18:28:33-04:00May 23, 2024|340b, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for May 17

The following is the latest health policy news from the federal government for May 10-17. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced a further extension of deadlines for fulfilling certain Medicaid unwinding requirements. Some current deadlines will be extended to December 31, 2024 and others through June 30, 2025. States also may seek to extend selected COVID-19-related flexibilities through June 30, 2025. Among the deadlines affected by this announcement are those for using ex parte information to determine eligibility; permitting Medicaid managed care organizations to help [...]

joe2024-05-17T20:18:34-04:00May 17, 2024|Centers for Medicare & Medicaid Services, health equity, hospitals, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, social determinants of health|

Federal Health Policy Update for May 9

The following is the latest health policy news from the federal government for May 3-9. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services HHS and CMS have announced the Increasing Organ Transplant Access Model, which seeks to increase access to kidney transplants for people living with end-stage renal disease (ESRD), improve the quality of care for people seeking kidney transplants, reduce disparities among individuals undergoing the process of receiving a kidney transplant, and increase the efficiency and capability of transplant hospitals selected to participate. Hospitals eligible to be selected for [...]

joe2024-05-09T20:32:32-04:00May 9, 2024|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, health equity, hospitals, Medicaid, Medicare, social determinants of health|

Federal Health Policy Update for May 2

The following is the latest health policy news from the federal government for April 26 – May 2. Some of the language used below is taken directly from government documents. No Surprises Act – Independent Dispute Resolution Process CMS has announced a new process for resubmitting Independent Dispute Resolution (IDR) disputes that were originally improperly batched or bundled.This new resubmission process is automated in the federal IDR portal and seeks to streamline federal IDR operations. For further information about this new process and an implementation timetable, see this CMS announcement. CMS also has posted a user guide for the IDR [...]

joe2024-05-02T19:49:55-04:00May 2, 2024|Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for April 25

The following is the latest health policy news from the federal government for April 9-25. Some of the language used below is taken directly from government documents. Updated 340B Arbitration Process Last week HHS’s Health Resources and Services Administration (HRSA) published a regulation modifying the administrative dispute resolution (ADR) process it uses to adjudicate payment disputes between 340B-eligible providers and pharmaceutical companies. The major changes in the ADR process include the use of HRSA experts to serve on ADR panels; elimination of the $25,000 damage threshold for filing a claim; 340B-eligible providers may now challenge manufacturers that seek to prevent [...]

joe2024-04-25T20:25:44-04:00April 25, 2024|340b, Accountable Care Organization, ACO, Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid long-term services and supports, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care, Medicaid regulations for the disabled, Medicare, Medicare post-acute care, Medicare regulations, post-acute care|

Federal Health Policy Update for April 18

The following is the latest health policy news from the federal government for April 12-18. Some of the language used below is taken directly from government documents. The White House The administration has launched a new global health security strategy that seeks to drive action across federal departments and agencies and rally support from other countries, the private sector, and civil society to better prevent, detect, respond to, and recover from infectious disease threats. The strategy seeks to build on the lessons learned from the response to the COVID-19 pandemic. Learn more from this White House statement; the administration’s strategy [...]

joe2024-04-18T19:03:57-04:00April 18, 2024|340b, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, MedPAC|

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. The April 2024 Commission meeting began with a presentation of a draft chapter on demographic data collection in Medicaid for the June Report to Congress. Racial and ethnic health disparities persist throughout the U.S. health care system. Previous meetings have focused on the collection of primary language and limited English proficiency, sexual orientation and gender identity (SOGI), and disability data to help assess and address these health disparities. Measuring differences in access and use of [...]

joe2024-04-16T17:34:59-04:00April 17, 2024|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid long-term services and supports, Medicaid regulations|

MedPAC Meets

Members of the Medicare Payment Advisory Commission met publicly last week in Washington, D.C. Their agenda consisted of the following issues: telehealth in Medicare alternative approaches to lowering Medicare payments for selected conditions in inpatient rehabilitation facilities considering approaches for updating the Medicare physician fee schedule assessing consistency between plan-submitted data sources for Medicare Advantage enrollees generic drug pricing under Part D initial findings from analysis of Medicare Part B payment rates and 340B ceiling prices Go here for a brief overview of each agenda item and links to the staff presentations on those issues. MedPAC is an independent congressional [...]

joe2024-04-16T15:35:18-04:00April 16, 2024|340b, Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|