hospitals

Federal Health Policy Update for July 9

Don’t Miss: CMS ends fast track process for Medicaid 1115 waiver renewals HHS publishes 2026 regulatory agenda HHS asks hospitals to sign healthy foods pledge The following is the latest health policy news from the federal government for July 3-9. Some of the language used below is taken directly from government documents. Congress Congress will return to session on July 13. Committees with jurisdiction over health care will continue focusing on legislation that could ultimately be incorporated into a reconciliation package, FY 2027 appropriations legislation, or other end-of-year legislation. Centers for Medicare & Medicaid Services (CMS) In the wake of [...]

joe2026-07-09T14:47:22-04:00July 9, 2026|Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy|

Administration, Congress, Press Hospitals for Reforms

Even at a time when passing major health care legislation in the near future becomes increasingly unlikely, the hospital community continues to face serious challenges from both the administration and Congress. The Centers for Medicare & Medicaid Services has proposed making more Medicare outpatient payments on a site-neutral basis and reducing Medicare payments to hospitals for prescription drugs covered by the 340B drug pricing program. It also threatens other changes in the 340B program that hospitals believe will make it more difficult – and costly – to participate in. Meanwhile, Congress is considering increasing federal oversight of the finances of [...]

joe2026-07-07T16:42:00-04:00July 8, 2026|340b, hospitals, Medicaid, Medicaid regulations|

Proposed Limits on Medicaid State-Directed Payments Explained

In late May, the Centers for Medicare & Medicaid Services proposed new restraints on state-directed Medicaid payments. In so doing, CMS was seeking to implement a mandate included in H.R. 1, last year’s federal budget reconciliation bill. Since 2016, states have been requiring Medicaid managed care plans to supplement their regular payments to selected Medicaid providers, especially hospitals, as a means of ensuring access to certain medical services in communities where such services are otherwise scarce. States, in turn, have been drawing down federal Medicaid matching funds for those additional payments, increasing federal Medicaid spending. Now, CMS is maintaining that [...]

joe2026-07-07T14:45:49-04:00July 8, 2026|hospitals, Medicaid, Medicaid managed care, Medicaid regulations|

Proposed Medicare Rule Could Hit Hospitals Hard

The Centers for Medicare & Medicaid Services’ proposed 2027 Medicare outpatient prospective payment system rule could pose several serious challenges to hospitals. Among them: A proposed increase of 2.4 percent in payments for outpatient services that could be reduced to only 0.6 percent if CMS adopts its proposal to accelerate its clawback from previous 340B litigation to a three percent reduction. The transition of still more imaging services to site-neutral payments and a prohibition against Medicare outpatient payments for off-campus hospital-based outpatient departments unless each department has its own National Provider Identifier (NPI) and an attestation from the main provider [...]

joe2026-07-07T12:02:42-04:00July 7, 2026|340b, hospitals, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for July 2

Don’t Miss: CMS proposes CY 2027 Medicare outpatient rates, reviving 340B cuts, expanding site-neutral payments CMS calls for modest Medicare home health pay hike, more ways to oust providers Court halts borrowing limit that jeopardized supply of qualified health professionals The following is the latest health policy news from the federal government for June 25-July 2. Some of the language used below is taken directly from government documents. Proposed CY 2027 Medicare Outpatient Prospective Payment and Ambulatory Surgical Center Rule CMS has published its proposed Medicare FY 2027 outpatient and ambulatory surgical center prospective payment system rule. The proposed [...]

joe2026-07-02T16:55:39-04:00July 2, 2026|340b, Accountable Care Organization, Affordable Care Act, Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

House Weighs Hospital Transparency Bill

A new bill in the House of Representatives would require most non-profit hospitals to provide more detailed financial information to the federal government to justify their continued tax-exempt status. The Tax Exempt Hospital Transparency Act, currently working its way through the House Ways and Means Committee, would apply, in general, to non-profit hospitals and hospital organizations with more than 100 staffed beds and more than $100 million in patient revenue. Affected tax-exempt hospitals would be required to report annually on how they have addressed the needs identified in their required community needs assessment – and explain why they are not [...]

joe2026-07-01T12:09:31-04:00July 2, 2026|340b, Congress, hospitals|

Federal Health Policy Update for June 25

Don’t Miss: CMS posts a new presentation on Medicaid eligibility under HR 1 House health subcommittee marks up health care price transparency bills Cassidy proposes 340B bill HRSA announces two maternity-related funding opportunities The following is the latest health policy news from the federal government for June 19-25. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Committee’s Oversight Subcommittee held a hearing to discuss integrity and fraud risk in state Medicaid programs; witnesses included state Medicaid directors from California, Minnesota, New York, and Ohio. For more information, see the press [...]

joe2026-06-25T17:28:47-04:00June 25, 2026|340b, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for June 18

Don’t Miss: 340B Rebate Model pilot program – next steps Stricter rules on CMS’s reviews of new and existing section 1115 Medicaid demonstration programs Changes in health care institution accrediting practices HHS posts mental and behavioral health grant opportunities The following is the latest health policy news from the federal government for June 12-18. Some of the language used below is taken directly from government documents. Congress Both chambers of Congress will return to session on June 22. The House Energy and Commerce Committee’s Oversight and Investigations Subcommittee will hold a hearing titled “State Medicaid Program Integrity: Examining Fraud Risks [...]

joe2026-06-18T16:07:51-04:00June 18, 2026|340b, Affordable Care Act, Alternative payment models, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

MACPAC Issues Report to Congress

The Medicaid and CHIP Payment and Access Commission has sent its 2026 report to Congress. The report – mandated by Congress – includes recommendations for: overseeing community engagement/work requirements in Medicaid, including MedPAC’s recommendation that the Centers for Medicare & Medicaid Services develop a transparent plan through which it can monitor and evaluate community engagement requirements improving CMS’s oversight of the use of automation in Medicaid prior authorization decisions improving the accountability of states’ Medicaid managed care programs appropriate access to residential treatment services for Medicaid-enrolled youth with special behavioral health needs and disabilities facilitating the transition of children and [...]

joe2026-06-17T09:45:11-04:00June 17, 2026|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations for long-term care|

MedPAC Reports to Congress

The Medicare Payment Advisory Commission has issued its annual report to Congress. This year’s report examines: how Medicare payment incentives affect federal spending and the delivery of care and how those incentives can be improved the challenges beneficiaries encounter when deciding on their enrollment in Medicare how Medicare identifies improper payments – and how it can do so more effectively the association between enrollment in Medicare Advantage plans and provider finances access to selected palliative care services under Medicare’s hospice benefit MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are not binding [...]

joe2026-06-16T16:58:28-04:00June 17, 2026|hospitals, Medicare, Medicare reimbursement policy|