Congress

MACPAC Reports to Congress

The Medicaid and CHIP Payment and Access Commission has issued its annual report to Congress on the state of Medicaid and the Children’s Health Insurance Program. The commission, a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the Department of Health and Human Services, and the states on a wide array of subjects, issues a report every year at this time. This year’s report focuses primarily on: Medicaid race and ethnicity data collection and reporting principles for assessing Medicaid nursing facility payment programs strengthening evidence under Medicaid drug coverage MACPAC’s [...]

admin2023-03-23T06:00:58+00:00March 23, 2023|Congress, hospitals, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

MedPAC Offers FY 2024 Rate Recommendations

Medicare rates would rise for some providers and fall for others based on recommendations made to Congress last week by the Medicare Payment Advisory Commission, the independent congressional agency that advises Congress on Medicare reimbursement matters. MedPAC’s rate recommendations to Congress and the administration, which it approved at its January 2023 meeting, are: Outpatient and inpatient prospective payment systems – under current law, the estimated increase would be about 2.9 percent; MedPAC proposes 2.9 percent plus one percent. Physician services – increase fees 50 percent of the projected increase in the medical economic index (MEI). Skilled nursing facilities – reduce [...]

admin2023-03-22T06:00:32+00:00March 22, 2023|Congress, hospitals, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for December 22

The following is the latest health policy news from the federal government for the week of December 19-22. Some of the language used below is taken directly from government documents. Congress As of this writing, Congress continues to work on an FY 2023 omnibus spending bill: the Senate has passed it but the House has not yet addressed it. Highlights of what negotiators have agreed to – but that have not yet been adopted – include: Preventing the additional four percent Medicare sequester for two years. Reducing by more than half the 4.5 percent cut in Medicare payments to physicians [...]

admin2022-12-22T17:30:38+00:00December 22, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, hospitals, Medicaid, Medicare, Medicare bad debt reimbursement, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15. Some of the language used below is taken directly from government documents. White House The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans. Learn more about the plan from this White House fact sheet and go here for a transcript of the White House [...]

MedPAC Considers 2023 Medicare Rates at December Meeting

The government agency that advises Congress on Medicare payment matters met publicly in Washington, D.C. last week. During the virtual meeting, members of the Medicare Payment Advisory Commission discussed and debated: Assessing payment adequacy and updating payments: hospital inpatient and outpatient services and supporting Medicare safety-net hospitals – commissioners discussed a proposal to increase FY 2024 rates one percentage point more than current law prescribes. Commissioners also discussed additional steps they might take to provide better support to safety-net hospitals, which they described as “…hospitals with high shares of low-income Medicare patients.” Status report: ambulatory surgical center services. Assessing payment [...]

admin2022-12-14T06:00:43+00:00December 14, 2022|Congress, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Before Recess, Congress Contemplates Medicaid

Before the current session of Congress comes to a close, lawmakers may consider a number of Medicaid issues. Among them: The future of Medicaid eligibility for those who enrolled in the program as a result of special provisions introduced in response to COVID-19. The process for reviewing the future eligibility of those currently enrolled in Medicaid. A movement to extend the current, temporary 12 months of postpartum Medicaid eligibility for new mothers and their newborns beyond the end of the current public health emergency. A gradual phasing out of the enhanced federal Medicaid matching funds states currently receive. Learn more [...]

admin2022-12-07T06:00:25+00:00December 7, 2022|Congress, Medicaid|

FEDERAL HEALTH POLICY UPDATE FOR December 1

The following is the latest health policy news from the federal government for the week of November 28 to December 1. Some of the language used below is taken directly from government documents. 340B HHS and its Health Resources and Services Administration (HRSA) have proposed revising the current 340B administrative dispute resolution process. Since the current process was introduced in 2020 HRSA has encountered policy and operational challenges with its implementation and now proposes revising it and is soliciting comment on its proposed new approach. Changes include changing the nature of the dispute resolution process, using different kinds of professionals [...]

117th Congress’s Waning Hours

In addition to its biggest challenge – funding the federal government, authorization for which ends on December 16 – Congress has a number of health care issues on its agenda that at least some lawmakers and health care industry stakeholders would like to see it address before the year ends. Those issues include the cut in Medicare payments to physicians scheduled to take place on January 1; the desire of many to make permanent some of the flexibilities to use telehealth that were temporarily authorized in response to the COVID-19 public health emergency; additional pandemic funding for new vaccines, new [...]

admin2022-11-17T06:00:49+00:00November 17, 2022|Congress, COVID-19, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for Monday, August 8`

The following is the latest health policy news from the federal government as of 2:30 p.m. on Monday, August 8. Some of the language used below is taken directly from government documents. Congress On Sunday, the Senate passed the Democrats’ health care, climate, and tax bill, H.R. 5376, The Inflation Reduction Act, by a vote of 51-50, with Vice President Harris casting the tie-breaking vote. Health care provisions in the reconciliation bill include: allowing Medicare to negotiate prescription drug prices limiting out-of-pocket prescription drug costs for Medicare enrollees to $2,000 a year extending for three years enhanced Affordable Care Act [...]

admin2022-08-08T16:12:06+00:00August 8, 2022|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, COVID-19, deficit reduction, Medicaid, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for Wednesday, July 27

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, July 27. Some of the language used below is taken directly from government documents. Final Medicare Payment Regulations for FY 2023 CMS has issued its final FY 2023 Medicare inpatient rehabilitation facility (IRF) payment system regulation, finalizing a rate increase of 3.9 percent, which is greater than the 2.8 percent the agency proposed in April. To learn more about CMS’s final IRF payment rule for FY 2023, see this CMS fact sheet and the final rule itself. CMS also has finalized its [...]

admin2022-07-27T17:34:40+00:00July 27, 2022|Centers for Medicare & Medicaid Services, Congress, COVID-19, Medicaid, Medicaid long-term services and supports, Medicaid managed care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|