COVID-19

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|

Feds Tackles State Medicaid Redetermination Problems With Penalties

The Centers for Medicare & Medicaid Services has unveiled plans to penalize states that fail to comply with federal standards for redetermining the eligibility of individuals who enrolled in their Medicaid programs during the COVID-19 emergency. Under a new CMS regulation, states that fail to report on their Medicaid eligibility efforts and comply with current requirements face penalties that include civil penalties and reductions in the rate at which the federal government matches state Medicaid expenditures. According to a new interim final rule, CMS is implementing … reporting requirements and enforcement authorities in the Social Security Act (the Act) that [...]

joe2023-12-05T16:30:03+00:00December 6, 2023|COVID-19, Medicaid|

Medicaid Redeterminations Trigger Increase in Self-Pay Care

As states continue redetermining Medicaid eligibility for participants who were protected from disenrollment during the COVID-19 emergency, the number of patients telling providers they will pay for their own hospital, primary care, and emergency department visits has risen. The increase in self-pay has been greatest for emergency department visits, and overall, the increases occurred most often in states that began disenrolling Medicaid participants as soon as the continuous eligibility afforded by the Families First Coronavirus Response Act ended. The rise in self-pay patients suggests that many previous Medicaid participants have not obtained new health insurance since their Medicaid eligibility ended. [...]

joe2023-11-30T19:16:48+00:00December 4, 2023|COVID-19, Medicaid|

Federal Health Policy Update for November 30

The following is the latest health policy news from the federal government for November 17-30. Some of the language used below is taken directly from government documents. No Surprises Act CMS has released two new FAQs to provide guidance in advance of the Independent Dispute Resolution portal reopening for batched disputes and air ambulance disputes; that service remains temporarily suspended. These FAQs together explain how certified IDR entities may determine whether a dispute is appropriately batched in light of recent court rulings; provide information about policy for extending existing IDR deadlines once the federal IDR portal reopens to all batched [...]

joe2023-11-30T20:59:02+00:00November 30, 2023|Centers for Medicare & Medicaid Services, COVID-19, Federal Update, Medicaid, 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 [...]

Federal Health Policy Update for November 2

The following is the latest health policy news from the federal government for October 27 – November 2. Some of the language used below is taken directly from government documents. 340B Remedy Payments Late Thursday afternoon CMS published its final Medicare remedy for underpayments for 340B prescription drugs that was implemented in 2018 but rejected by the Supreme Court last year. According to the regulation, 340B remedy payments to hospitals will be made after this rule takes effect, which is 60 days after it is officially published in the Federal Register; publication is scheduled for November 16. The final regulation [...]

admin2023-11-02T18:01:15+00:00November 2, 2023|340b, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare reimbursement policy|

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 [...]

admin2023-10-19T15:01:13+00:00October 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|

Federal Health Policy Update for October 12

The following is the latest health policy news from the federal government for October 6-12. Some of the language used below is taken directly from government documents. No Surprises Act CMS has reopened the federal independent dispute resolution (IDR) portal for the initiation ofnew single disputes, including single disputes involving bundled payment arrangements, but parties still cannot initiate new disputes involving air ambulance services and batched disputes for air ambulance and non-air ambulance items and services. IDR portal functionalities related to previously initiated batched disputes also are unavailable. Learn more about this action from this CMS announcement, which includes an [...]

admin2023-10-12T14:42:15+00:00October 12, 2023|COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, social determinants of health, Telehealth|

DEA Okays Continued Remote Prescribing of Controlled Substances

The federal Drug Enforcement Administration has extended the authority of qualified health care providers to prescribe controlled substances via telehealth through the end of 2024. This authorization originated as a temporary measure in response to the COVID-19 public health emergency and this is its second extension since the end of the formal public health emergency. The DEA says it intends to promulgate new remote prescribing standards by the fall of 2024. Without the extension, the authority would have expired on November 11. Learn more about this DEA decision, why it was made, and what to expect next from this Federal [...]

admin2023-10-11T06:00:23+00:00October 11, 2023|COVID-19, Telehealth|

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 [...]

admin2023-10-05T14:53:32+00:00October 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|