CMMI

Federal Health Policy Update for October 27

The following is the latest health policy news from the federal government for the week of October  21 to October 27.  Some of the language used below is taken directly from government documents. 340B Responding to a federal court ruling that the federal government has shortchanged hospitals in its payments for 340B-covered prescription drugs, CMS has announced how it will compensate hospitals for its underpayments – at least for the 2023 fiscal year.  According to CMS, it “…will apply the default rate (generally ASP plus 6%) to 340B-acquired drugs for the rest of the year.  CMS also will reprocess claims [...]

FEDERAL HEALTH POLICY UPDATE FOR OCTOBER 20

The following is the latest health policy news from the federal government for the week of October 14 to October 20.  Some of the language used below is taken directly from government documents. White House President Biden has signed an executive order on lowering prescription drug costs.  The order directs HHS to consider additional actions to further drive down prescription drug costs, encourages it to pursue such actions through its Center for Medicare and Medicaid Innovation (CMMI), and directs HHS to submit a formal report within 90 days outlining any plans to use CMMI’s authority to lower drug costs and [...]

Federal Health Policy Update for October 6

The following is the latest health policy news from the federal government for the week of September 26 to October 6.  Some of the language used below is taken directly from government documents. 340B HHS must immediately end its significant cut in reimbursement for 340B-covered prescription drugs provided on an outpatient basis to eligible patients, a federal court has ruled, writing that “The prospective portion of the 2022 reimbursement rate shall be vacated because it is defective and because vacating this portion of the 2022 OPPS Rule will not cause substantial disruption” and that “HHS should not be allowed to [...]

Federal Health Policy Update for the Week of September 5-12

The following is the latest health policy news from the federal government for the week of September 5-12.  Some of the language used below is taken directly from government documents. The White House The White House has published a fact sheet on the administration’s plan to get Americans an updated COVID-19 shot and to manage COVID-19 this fall.  The major components of the plan are providing access to free, updated vaccines; ensuring easy access to testing and treatment; encouraging safe practices; and preparing for potential surges and new variants.  Find that fact sheet here. The White House’s COVID-19 response team [...]

Federal Health Policy Update for Thursday, July 7

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, July 7.  Some of the language used below is taken directly from government documents. The Courts Hospitals may sue state Medicaid programs for failing to ensure that private insurers – such as Medicaid managed care plans – pay hospitals in a timely manner for the care they provide to their Medicaid patients, a federal appeals court has ruled.  See the court’s decision in this case. Centers for Medicare & Medicaid Services CMS has proposed a series of changes in the Medicare cost [...]

Federal Health Policy Update for Monday, June 27

The following is the latest health policy news from the federal government as of 2:15 p.m. on Monday, June 27.  Some of the language used below is taken directly from government documents. White House The White House COVID-19 response team has briefed the press about the administration’s latest efforts in the response to COVID-19.  Find a transcript of that briefing here and find the slides presented during that briefing here. Supreme Court In a case that challenged a 2005 change in how CMS calculates Medicare disproportionate share (Medicare DSH) payments, the Supreme Court has, in a 5-4 decision, reversed a [...]

Federal Health Policy Update for Monday, June 13

The following is the latest health policy news from the federal government as of 2:30 p.m. on Monday, June 13.  Some of the language used below is taken directly from government documents. White House The White House has issued a fact sheet outlining its plan for administering COVID-19 vaccines to children under the age of five.  Find the fact sheet here.  The White House also held a background call with the press to discuss this plan; go here to see a transcript of that call. The White House COVID-19 response team has held a briefing for the press to discuss [...]

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 [...]

Federal Health Policy Update for Friday, April 1

The following is the latest health policy news from the federal government as of 2:30 p.m. on Friday, April 1.  Some of the language used below is taken directly from government documents. Provider Relief Fund After April 5, this program also will stop accepting claims for administering vaccines to uninsured individuals.  See this notice for further information about both deadlines for submitting claims. Proposed Medicare Payment Regulations for FY 2023 CMS has published its proposed inpatient rehabilitation facility (IRF) prospective payment system and IRF quality reporting program for FY 2023.  The agency proposes a 2.8 percent net increase in Medicare [...]

Federal Health Policy Update for Wednesday, March 30

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, March 30.  Some of the language used below is taken directly from government documents. Provider Relief Fund The Provider Relief Fund last week distributed more than $413 million to more than 3600 providers across the country, the fourth round of Phase 4 payments since those payments began last November.  This is in addition to nearly $7.5 billion in American Rescue Plan (ARP) Rural payments over the past four months.  HHS’s Health Resources and Services Administration (HRSA), which administers the Provider Relief Fund, [...]

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