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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 [...]

Federal Health Policy Update for September 28

The following is the latest health policy news from the federal government for September 22-28.  Some of the language used below is taken directly from government documents. The White House President Biden has signed H.R. 2544, the Securing the U.S. Organ Procurement and Transplantation Network Act,  which provides for awarding multiple grants, contracts, or cooperative agreements to operate the Organ Procurement and Transplantation Network. Congress Congressional leaders have not come to agreement on how to avert a federal government shutdown this weekend.  While Senate leaders introduced a continuing resolution that would fund the government through November 17, that bill has [...]

Federal Health Policy Update for September 21

The following is the latest health policy news from the federal government for September 15 - 21.  Some of the language used below is taken directly from government documents. Congress With only nine days left in the current federal fiscal year, Congress still has not agreed on any kind of spending bill to keep the federal government operating past September 30.  If the federal government shuts down, the Department of Health and Human Services (HHS) will “use the full extent of the authority under the Antideficiency Act (ADA) to maintain existing HHS activities…”  In previous shutdowns, Medicare has continued to [...]

Federal Health Policy Update for September 14

The following is the latest health policy news from the federal government for September 8-14.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has posted a guide providing details about how it calculates scores for its Merit-Based Incentive Payment System in the 2023 performance year.  Find the guide by going here, scrolling down to “Full Resource Library,” and clicking “2023 Traditional MIPS Scoring Guide” for a direct download of the guide. CMS has posted a notice about a data breach at a CMS contractor, Maximus Federal Services, Inc. (Maximus), [...]

Federal Health Policy Update for August 24

The following is the latest health policy news from the federal government for August 11-24.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services After suspending the No Surprises Act-created Independent Dispute Resolution process in the wake of a court ruling striking down a recent increase in fees for that process, CMS has established a new rate structure for initiating the adjudication of payment disagreements between providers and payers.  It explains the new rate structure in this new FAQ, which nevertheless notes that despite the creation of new rates, the Independent [...]

Federal Health Policy Update for August 10

The following is the latest health policy news from the federal government for August 4-10.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has temporarily suspended the federal Independent Dispute Resolution process, which adjudicates problems involving surprise medical bills, in the wake of a federal court ruling that found some of the process’s underlying regulations invalid.  CMS has directed the certified Independent Dispute Resolution entities to pause all dispute resolution activities.  As a result, providers and insurers temporarily cannot initiate new disputes.  Learn more from this CMS notice. CMS [...]

Federal Health Policy Update for August 3

The following is the latest health policy news from the federal government for July 29-August 3.  Some of the language used below is taken directly from government documents. Medicare Payment Regulations CMS has issued a final rule updating Medicare payment policies and rates for inpatient and long-term-care hospital services under its inpatient prospective payment system and long-term care prospective payment system for FY 2024.  The final rule increases hospital inpatient rates 3.1 percent and LTCH rates 3.3 percent in FY 2024.  Other highlights include a nearly $1 billion cut in Medicare disproportionate share (Medicare DSH) and Medicare DSH uncompensated care [...]

Some States Struggling With Medicaid Eligibility Redeterminations

As many as 12 states have struggled to comply with federal guidelines for redetermining eligibility of their Medicaid population – enough so that the federal government has had to intervene. The Centers for Medicare & Medicaid Services has reportedly halted Medicaid eligibility redeterminations in six states since April and worked closely with six more after concluding that they were not complying with its guidelines for how to go about redetermining the eligibility of the nearly 94 million Americans who were on the Medicaid rolls when the COVID-19 public health emergency ended.  During that emergency, many people became newly eligible for [...]

Federal Health Policy Update for July 20

The following is the latest health policy news from the federal government for March 13-16.  Some of the language used below is taken directly from government documents. Congress Senator Bernie Sanders (I-VT), chair of the Senate Health, Education, Labor and Pensions (HELP) Committee, has introduced a bill, the “Primary Care and Health Workforce Expansion Act.”  The bill would: Increase funding for community health centers by $65 billion over five years, fund the National Health Service Corps at $8.3 billion over five years, and provide $250 million for HRSA coordination for the Women, Infants, and Children (WIC) program. Add 10,000 graduate [...]

Federal Health Policy Update for July 13

The following is the latest health policy news from the federal government for June 30 – July 13.  Some of the language used below is taken directly from government documents. 340B CMS has published a proposed regulation outlining how it plans to reimburse hospitals for reductions in 340B prescription drug payments that it implemented from 2018 to 2022 but that a federal court found to be illegal.  The agency calculates that it owes participating 340B providers $9 billion, which it proposes paying to those providers in single lump-sum payments.  CMS also proposes offsetting these payments through reductions in future non-drug [...]

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