COVID-19

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|

Medicaid Unwinding Extended

The federal government is giving states more time to complete their Medicaid unwinding process – and people still on the Medicaid rolls more time to apply to retain their Medicaid eligibility. In a memo to state Medicaid programs, the Centers for Medicare & Medicaid Services wrote that To continue supporting states’ efforts to establish and update income and eligibility determination systems that maximize states’ ability to ensure that eligible individuals retain coverage, CMS is further extending these unwinding-related…waivers through June 30, 2025. When the Families First Coronavirus Response Act’s prohibition against removing people from state Medicaid rolls ended with the [...]

joe2024-05-15T17:07:11-04:00May 15, 2024|COVID-19, Medicaid|

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 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|

Federal Health Policy Update for April 12

The following is the latest health policy news from the federal government for April 5-11. Some of the language used below is taken directly from government documents. CMS – Proposed FY 2025 Medicare Inpatient Prospective Payment System Regulation Earlier this week CMS issued its proposed FY 2025 Medicare inpatient prospective payment system regulation – the rule under which it envisions paying acute-care hospitals, critical access hospitals, and long-term care hospitals for inpatient care in the coming fiscal year. Highlights of the proposed rule include: Rate increases of 2.6 percent for acute-care and critical access hospitals and 2.8 percent for LTCHs. [...]

Medicaid Unwinding After One Year

The process known as “Medicaid unwinding” has now been under way for a year. When Congress expanded Medicaid eligibility in response to the COVID-19 pandemic it also banned states from removing participants from their Medicaid rolls; the penalty for doing so was reduced federal Medicaid funding, a price no state was willing to pay. During the course of the pandemic, nationwide Medicaid enrollment rose 22 million, to 94 million last March. But a year ago states were directed to begin reviewing the eligibility of those then on their Medicaid rolls and to remove those who no longer met eligibility criteria. [...]

joe2024-04-02T20:56:42-04:00April 3, 2024|COVID-19, Medicaid|

Federal Health Policy Update for March 28

The following is the latest health policy news from the federal government for March 22-28. Some of the language used below is taken directly from government documents. The Cyberattack on Change Healthcare HHS, its Administration for Strategic Preparedness and Response, and CMS have published a resource guide for providers seeking assistance in response to the Change Healthcare cyberattack. Find that guide here. Centers for Medicare & Medicaid Services CMS has issued a proposed rule to update Medicare payment policies and rates under its Inpatient Rehabilitation Facility (IRF) Prospective Payment System and the IRF Quality Reporting Program (QRP) for FY 2025. The proposed rule [...]

joe2024-03-28T19:23:45-04:00March 28, 2024|Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for February 29

The following is the latest health policy news from the federal government for February 23-29. Some of the language used below is taken directly from government documents. Congress This afternoon the House passed H.R. 7463, which changed the dates for the March 1 and March 8 funding deadlines to March 8 and March 22 and includes no new health care policies. Health care extenders included in the current continuing resolution, including the delay to Medicaid DSH cuts, are not included in the bill that passed the House; the March 8 expiration date still applies to those extenders. The new continuing [...]

joe2024-02-29T22:41:47-05:00February 29, 2024|Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for February 22

The following is the latest health policy news from the federal government for February 16-22. Some of the language used below is taken directly from government documents. CMS and Medicaid DSH Payments CMS has published a final rule governing how third-party payers are factored into the calculation of hospitals’ Medicaid disproportionate share hospital-specific payment limit. This change requires that the calculation be based solely on Medicaid costs and payments and that costs and payments associated with dually eligible (Medicare and Medicaid) patients be excluded from the calculation of that limit. The effect of this change is that hospitals that are [...]

joe2024-02-22T22:00:03-05:00February 22, 2024|Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations, Medicaid upper-payment limit, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|