Congress

Federal Health Policy Update for March 21

The following is the latest health policy news from the federal government for March 15-21. Some of the language used below is taken directly from government documents. The White House The White House has announced new actions to advance women’s health research and innovation and issued an executive order in support of that objective. The order directs executive branch agencies to integrate women’s health across the federal research portfolio; prioritize investments in women’s health research; pursue new research on women’s midlife health; and assess unmet needs to support women’s health research. Learn more from this White House fact sheet, which [...]

MedPAC Recommends Medicare Rate Updates to Congress

Some health care providers deserve larger Medicare payments in 2025, some should receive payment cuts, and others should see their payments go unchanged according to new recommendations from the Medicare Payment Advisory Commission to Congress. In its annual report to Congress, MedPAC recommended the following changes in Medicare rates for 2025: Medicare inpatient rates – the rate increase currently scheduled by law for 2025 plus 1.5 percent. Medicare outpatient rates – the rate increase currently scheduled by law for 2025 plus 1.5 percent. Medicare physician rates – the rate increase for physician and other health professional services currently scheduled by [...]

joe2024-03-19T21:02:54+00:00March 20, 2024|Centers for Medicare & Medicaid Services, Congress, hospitals, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for March 14

The following is the latest health policy news from the federal government for March 8-14. Some of the language used below is taken directly from government documents. The White House The Biden administration this week released its proposed FY 2025 federal budget. Health care highlights include: Making permanent the expanded health care premium tax credits introduced to make health insurance marketplace plans more affordable for middle-class Americans. Extension of coverage similar to Medicaid to residents of the 10 states that have not taken advantage of the Affordable Care Act opportunity to expand their Medicaid programs. Permission for states to extend [...]

joe2024-03-14T20:46:56+00:00March 14, 2024|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for March 7

The following is the latest health policy news from the federal government for March 1-7. Some of the language used below is taken directly from government documents. Congress On Wednesday, March 16 the House passed, by a vote of 339-85, the first package of spending bills to fund some federal agencies through the remainder of the 2024 federal fiscal year. The House bills include several health care provisions extending programs that were set to expire on Friday, March 8. The bills would extend the following provisions and programs through December 31, 2024: The continued delay of cuts to Medicaid disproportionate [...]

joe2024-03-07T21:42:53+00:00March 7, 2024|Alternative payment models, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

Medicaid DSH Cut In, Medicare Site-Neutral Payments Out of Health Bill?

With Congress at a stalemate on spending legislation, lawmakers are considering a narrower scope of issues to address in near-term health care legislation. According to published reports, scheduled cuts in Medicaid disproportionate share allotments to states (Medicaid DSH), already delayed several times, could be delayed once again. In addition, a proposal to require Medicare to pay for outpatient services on a site-neutral basis, rather than paying higher rates to hospital-based outpatient departments higher rates, might not be included. Also under consideration: restoring some cuts in Medicare’s payments to physicians and additional funding for community health centers. Also in jeopardy at [...]

joe2024-02-27T18:53:55+00:00February 28, 2024|Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare cuts, Medicare reimbursement policy|

New Way of Calculating Medicaid DSH

Hospitals will soon see federal regulators take a new approach to calculating their Medicaid DSH payments. Specifically, their Medicaid disproportionate share hospital-specific payment limit. A new CMS regulation changes how third-party payments are factored into the calculation of hospitals’ Medicaid disproportionate share hospital-specific payment limit. That limit, in turn, affects hospitals’ Medicaid DSH payments. This final rule implements changes CMS proposed last year to comply with a congressional mandate to include in the calculation of hospitals’ Medicaid disproportionate share hospital-specific payment limits only costs and payments for services furnished to beneficiaries for whom Medicaid is the primary payer; this means [...]

joe2024-02-23T16:37:23+00:00February 26, 2024|Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH|

Proposal Would Establish New “Essential Health System” Designation

The newly proposed “Reinforcing Essential Health Systems for Communities Act” would create a new federal hospital designation that would create a mechanism for directing more federal resources to safety-net hospitals that care for more low-income and uninsured patients. The bipartisan bill, sponsored by Representatives Lori Trahan (D-MA) and David Valadao (R-CA), would, according to Rep. Trahan, … provide federal lawmakers with the avenues necessary to target funding and resources to these critical facilities – just as we’ve done with other types of hospitals that serve specific populations or regions. Hospitals would qualify for “essential health system” status by meeting one [...]

joe2024-02-20T17:02:55+00:00February 20, 2024|Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for December 7

The following is the latest health policy news from the federal government for December 1-7. Some of the language used below is taken directly from government documents. Congress While Congress has more than a month before the next federal funding deadline of January 19, committees are working to prepare and pass health care legislation. On the House calendar for floor votes next week is H.R. 5378, the Lower Costs, More Transparency Act. This bill would eliminate the pending cuts to Medicaid DSH for two years (those cuts are temporarily suspended through January 19); introduce site-neutral payments for drug administration services [...]

joe2023-12-07T21:50:17+00:00December 7, 2023|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for November 16

The following is the latest health policy news from the federal government for November 10-16. Some of the language used below is taken directly from government documents. Congress This week Congress passed another continuing resolution (CR) to fund the federal government beyond Friday, when the current CR expires. This bill establishes two separate deadlines for lawmakers to pass certain spending bills so they can avoid an omnibus bill that includes all 12 appropriations bills. Congress must pass four of the spending bills by January 19 and the other bills by February 2. The Labor, HHS, and Education bill, one of [...]

Bill Would Halt Medicaid DSH Cuts, Bring Other Changes

A wide-ranging bill passed by the Senate Finance Committee would eliminate $16 billion in Medicaid disproportionate share (Medicaid DSH) payments over the next two years. The Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, passed by the committee with unanimous, bipartisan support, also seeks to improve access to mental health care for Medicare patients living in rural and underserved areas; improve access to behavioral health services via telehealth for Medicaid and CHIP beneficiaries; reduce some of the recently adopted cuts in Medicare payments to physicians that will take effect in 2024; toughen federal regulations governing pharmacy benefit managers (PBMs); [...]

admin2023-11-15T13:00:58+00:00November 15, 2023|Congress, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicare reimbursement policy, Telehealth|