hospitals

Federal Health Policy Update for August 22

The following is the latest health policy news from the federal government for August 16-22. Some of the language used below is taken directly from government documents. The Courts The federal government must include uninsured patients whom hospitals serve under state Medicaid waivers when calculating hospitals’ Medicare DSH payments, a federal court has ruled. In the case of Baylor All Saints Medical Center, et al. v. Xavier Becerra, federal policymakers had invoked a 2023 regulation that excluded counting care provided to patients served by DSH-eligible hospitals providing care through state Medicaid waivers – generally, through uncompensated care pools. A group [...]

joe2024-08-22T15:11:48-04:00August 22, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for August 8

The following is the latest health policy news from the federal government for August 3-8. Some of the language used below is taken directly from government documents. No Surprises Act A federal appeals court has upheld a February lower court ruling that found that the current No Surprises Act’s arbitration process for addressing payment disagreements between payers and providers favored payers by giving too much weight to “qualifying payment amounts,” which are the median of what insurers contract to pay providers in a given geographic area. Learn more from the appeals court’s decision in the case. Department of Health and [...]

joe2024-08-08T15:01:05-04:00August 8, 2024|340b, Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, social determinants of health, Telehealth|

Federal Health Policy Update for July 18

The following is the latest health policy news from the federal government for July 13-18. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has issued a notice alerting certain clinicians who are qualifying alternative payment model (APM) participants and who have earned an APM incentive payment that the agency does not have the current contact information it needs to disburse their payments. The notice provides information to qualified participants on how to update their Medicare billing information so that CMS can disburse these payments. Learn more from this CMS [...]

joe2024-07-18T20:57:21-04:00July 18, 2024|Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|

MedPAC Posts Annual Data Book

The Medicare Payment Advisory Commission has published its annual data book Health Care Spending and the Medicare Program. The book provides information on national health care and Medicare spending, Medicare beneficiary demographics, and data on dual-eligible beneficiaries, quality of care in the Medicare program, and Medicare beneficiary and other payer liabilities. MedPAC presents its data in 11 sections: national health care and Medicare spending Medicare beneficiary demographics Medicare beneficiary and other payer financial liability dual-eligible beneficiaries alternative payer models acute inpatient services – general acute-care hospitals and inpatient psychiatric hospitals ambulatory care – physicians and other health professionals, hospital outpatient [...]

joe2024-07-17T12:02:47-04:00July 17, 2024|Alternative payment models, Centers for Medicare & Medicaid Services, health equity, hospitals, Medicaid, Medicare, Medicare post-acute care, post-acute care, Telehealth|

Federal Health Policy Update for July 12

The following is the latest health policy news from the federal government for July 6-12. Some of the language used below is taken directly from government documents. The Courts A federal court has blocked implementation of the FTC’s rule banning non-compete clauses in most employment contracts, a regulatory development with potentially significant implications for the health care industry. The temporary ban affects only the five plaintiffs in the case and it is not yet clear whether the ruling will have broader implications in the wake of the recent reversal of the Chevron decision that could potentially curtail the rulemaking authority [...]

joe2024-07-12T18:46:49-04:00July 12, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, hospitals, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for July 5

The following is the latest health policy news from the federal government for June 29-July 5. Some of the language used below is taken directly from government documents. Department of Health and Human Services Because it has found that Medicare Advantage organizations sometimes deny prior authorization requests for post-acute care after a qualifying hospital stay even though the requests met Medicare coverage rules, HHS’s Office of the Inspector General will examine selected Medicare Advantage plans’ processes for reviewing prior authorization requests for post-acute care in long-term acute-care hospitals, inpatient rehabilitation facilities, and skilled nursing facilities. It also will review the [...]

joe2024-07-05T17:44:35-04:00July 5, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare reimbursement policy, post-acute care|

Federal Health Policy Update for June 28

The following is the latest health policy news from the federal government for June 21-28. Some of the language used below is taken directly from government documents. The Courts The Supreme Court has overturned the court’s own decision in the 1984 case of Chevron U. S. A. Inc. v. Natural Resources Defense Council, Inc. that gave federal agencies considerable leeway to interpret ambiguous laws enacted by Congress. While the Chevron decision called for the courts to defer to federal agency interpretation of ambiguous statutes if they found them to be reasonable, the latest Supreme Court decision calls for the courts [...]

joe2024-06-28T20:03:06-04:00June 28, 2024|Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for June 13

The following is the latest health policy news from the federal government for June 7-13. Some of the language used below is taken directly from government document. Supreme Court The Supreme Court has agreed to hear a challenge to how the Department of Health and Human Services calculates hospitals’ Medicare disproportionate share (Medicare DSH) payments. The case was added to the court’s 2024-2025 schedule. Congress Individual members and key committees in Congress continue to introduce and mark up health care-related legislation with an eye toward including these initiatives in an end-of-year package. This work is expected to continue through the [...]

joe2024-06-13T20:15:06-04:00June 13, 2024|Alternative payment models, Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

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|

Federal Health Policy Update for May 23

The following is the latest health policy news from the federal government for May 18-23. Some of the language used below is taken directly from government documents. Congress Leaders of the Senate Finance Committee have released a white paper outlining potential reforms of how Medicare pays physicians and how Medicare might better meet the needs of those with chronic illnesses. The white paper notes areas of interest the committee sees as opportunities for reform, including: Creating sustainable payment updates to ensure clinicians can own and operate their practices. Creating incentives for alternative payment models that reward providing better care at [...]

joe2024-05-23T18:28:33-04:00May 23, 2024|340b, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|