Centers for Medicare & Medicaid Services

Federal Health Policy Update for October 19

The following is the latest health policy news from the federal government for October 13-19. Some of the language used below is taken directly from government documents. Congress At this moment there is still no Speaker of the House of Representatives. After 20 and then 22 House Republicans voted against Rep. Jim Jordan (R-Ohio) on Tuesday and Wednesday this week, Mr. Jordan has joined others, including senior Democrats, in supporting a plan to expand the powers of the temporary speaker, Rep. Patrick McHenry (R-NC). Mr. Jordan remains the speaker designee, an option that will enable him to continue to seek [...]

iqtsupport2023-10-19T15:01:13-04:00October 19, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare post-acute care, Medicare reimbursement policy, Telehealth|

MedPAC Meets

The members of the Medicare Payment Advisory Commission held their latest public meeting last week. The issues addressed during the meeting were: Current legal updates to Medicare’s payment rates for clinician services. Staffing ratios and turnover rates in nursing facilities. An alternative method to establish Medicare payments for selected conditions treated in inpatient rehabilitation facilities. A staff work plan for examining prices of generic drugs under Part D For an overview of each of these issues and links to the presentations made by MedPAC’s staff during the discussions, go here.

iqtsupport2023-10-12T13:00:04-04:00October 12, 2023|Centers for Medicare & Medicaid Services, Medicare, Medicare reimbursement policy, MedPAC, post-acute care|

Federal Health Policy Update for October 5

The following is the latest health policy news from the federal government for September 29 to October 5. Some of the language used below is taken directly from government documents. Congress Last Saturday, Congress passed a 45-day continuing resolution (CR) to fund the federal government through November 17. Part of that limited CR includes a delay of the scheduled $8 billion cut to Medicaid DSH allotments to states through the end of the CR. The bill also extends funding for community health centers and the National Health Services Corps for the same length of time. Congress will have to act [...]

iqtsupport2023-10-05T14:53:32-04:00October 5, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for September 28

The following is the latest health policy news from the federal government for September 22-28. Some of the language used below is taken directly from government documents. The White House President Biden has signed H.R. 2544, the Securing the U.S. Organ Procurement and Transplantation Network Act, which provides for awarding multiple grants, contracts, or cooperative agreements to operate the Organ Procurement and Transplantation Network. Congress Congressional leaders have not come to agreement on how to avert a federal government shutdown this weekend. While Senate leaders introduced a continuing resolution that would fund the government through November 17, that bill has [...]

iqtsupport2023-09-28T16:38:25-04:00September 28, 2023|Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Telehealth|

Federal Health Policy Update for September 14

The following is the latest health policy news from the federal government for September 8-14. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has posted a guide providing details about how it calculates scores for its Merit-Based Incentive Payment System in the 2023 performance year. Find the guide by going here, scrolling down to “Full Resource Library,” and clicking “2023 Traditional MIPS Scoring Guide” for a direct download of the guide. CMS has posted a notice about a data breach at a CMS contractor, Maximus Federal Services, Inc. (Maximus), [...]

iqtsupport2023-09-14T16:59:54-04:00September 14, 2023|Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicare|

Federal Health Policy Update for September 7

The following is the latest health policy news from the federal government for September 1-7. Some of the language used below is taken directly from government documents. Congress House Republicans plan to introduce the Lower Cost, More Transparency Act for consideration before the end of the year. This bill includes provisions passed by three committees with health care jurisdiction: House Ways & Means, Energy & Commerce, and Education & Workforce. Some of the bill’s provisions would: eliminate scheduled Medicaid DSH cuts for FY 2024 and FY 2025; reauthorize and extend funding for the Community Health Center program, the National Health [...]

iqtsupport2023-09-07T16:39:42-04:00September 7, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|

Federal Health Policy Update for August 31

The following is the latest health policy news from the federal government for August 25-31. Some of the language used below is taken directly from government documents. No Surprises Act For the second time in less than a month a court has rejected how federal agencies are implementing the Independent Dispute Resolution process of the No Surprises Act. A federal court concluded that the process for establishing the Qualifying Payment Amount, or QPA – the median rate insurers pay for in-network services and a critical factor in settling payment disputes – inappropriately permits insurers to depress that rate and unfairly [...]

iqtsupport2023-08-31T16:09:59-04:00August 31, 2023|Centers for Medicare & Medicaid Services, Medicaid, Medicare, MedPAC|

Court Again Sets Back No Surprises Act Implementation

For the second time in less than a month, a federal court has rejected the manner in which federal agencies are implementing the Independent Dispute Resolution process of the No Surprises Act, the 2020 law designed to protect consumers from surprise medical bills. In its ruling the court found that the process established by federal agencies to establish the Qualifying Payment Amount, or QPA, which is the median rate insurers pay for in-network services and a critical factor in adjudicating payment disputes between providers and payers, inappropriately permits insurers to depress that rate – a result the court likened to [...]

iqtsupport2023-08-30T06:00:15-04:00August 30, 2023|Centers for Medicare & Medicaid 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 [...]

Hospitals Continue to Protest Medicare DSH Cut

The regulation has already been finalized but hospitals continue to protest Medicare’s intention to reduce their Medicare disproportionate share (Medicare DSH) uncompensated care payments. The cut, proposed at $115 million in April, when the Centers for Medicare & Medicaid Services proposed it, ended up just shy of $1 billion in the final regulation. The major change, according to CMS, comes because the agency’s actuaries have projected a lower uninsured rate than when CMS proposed the $115 million cut in the spring. Medicare DSH payments are intended to help hospitals that care for especially large numbers of uninsured patients with the [...]

iqtsupport2023-08-17T06:00:38-04:00August 17, 2023|Centers for Medicare & Medicaid Services, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy|