hospitals

Federal Health Policy Update for March 14

The following is the latest health policy news from the federal government for March 8-14. Some of the language used below is taken directly from government documents. The White House The Biden administration this week released its proposed FY 2025 federal budget. Health care highlights include: Making permanent the expanded health care premium tax credits introduced to make health insurance marketplace plans more affordable for middle-class Americans. Extension of coverage similar to Medicaid to residents of the 10 states that have not taken advantage of the Affordable Care Act opportunity to expand their Medicaid programs. Permission for states to extend [...]

joe2024-03-14T20:46:56-04:00March 14, 2024|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|

Rural Hospitals Losing Money, Slashing Services, Mulling Future

Roughly half of rural hospitals lost money last year, according to a new report. Those struggles, moreover, are not a one-time thing: more than 40 percent were in the same position a year ago and more such hospitals are expected to be in this position a year from now. The problem is worse, moreover, for hospitals in states that did not take advantage of the Affordable Care Act option of expanding their Medicaid programs. In response to these challenges, some rural hospitals are discontinuing services like obstetrics – a serious challenge for hospitals located in isolated communities; exploring Medicare’s new [...]

joe2024-03-13T14:54:41-04:00March 13, 2024|hospitals, Medicaid, Medicare|

Federal Health Policy Update for March 7

The following is the latest health policy news from the federal government for March 1-7. Some of the language used below is taken directly from government documents. Congress On Wednesday, March 16 the House passed, by a vote of 339-85, the first package of spending bills to fund some federal agencies through the remainder of the 2024 federal fiscal year. The House bills include several health care provisions extending programs that were set to expire on Friday, March 8. The bills would extend the following provisions and programs through December 31, 2024: The continued delay of cuts to Medicaid disproportionate [...]

joe2024-03-07T21:42:53-05:00March 7, 2024|Alternative payment models, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

Medicaid DSH Cut In, Medicare Site-Neutral Payments Out of Health Bill?

With Congress at a stalemate on spending legislation, lawmakers are considering a narrower scope of issues to address in near-term health care legislation. According to published reports, scheduled cuts in Medicaid disproportionate share allotments to states (Medicaid DSH), already delayed several times, could be delayed once again. In addition, a proposal to require Medicare to pay for outpatient services on a site-neutral basis, rather than paying higher rates to hospital-based outpatient departments higher rates, might not be included. Also under consideration: restoring some cuts in Medicare’s payments to physicians and additional funding for community health centers. Also in jeopardy at [...]

joe2024-02-27T18:53:55-05:00February 28, 2024|Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare cuts, Medicare reimbursement policy|

New Way of Calculating Medicaid DSH

Hospitals will soon see federal regulators take a new approach to calculating their Medicaid DSH payments. Specifically, their Medicaid disproportionate share hospital-specific payment limit. A new CMS regulation changes how third-party payments are factored into the calculation of hospitals’ Medicaid disproportionate share hospital-specific payment limit. That limit, in turn, affects hospitals’ Medicaid DSH payments. This final rule implements changes CMS proposed last year to comply with a congressional mandate to include in the calculation of hospitals’ Medicaid disproportionate share hospital-specific payment limits only costs and payments for services furnished to beneficiaries for whom Medicaid is the primary payer; this means [...]

joe2024-02-23T16:37:23-05:00February 26, 2024|Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH|

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|

Proposal Would Establish New “Essential Health System” Designation

The newly proposed “Reinforcing Essential Health Systems for Communities Act” would create a new federal hospital designation that would create a mechanism for directing more federal resources to safety-net hospitals that care for more low-income and uninsured patients. The bipartisan bill, sponsored by Representatives Lori Trahan (D-MA) and David Valadao (R-CA), would, according to Rep. Trahan, … provide federal lawmakers with the avenues necessary to target funding and resources to these critical facilities – just as we’ve done with other types of hospitals that serve specific populations or regions. Hospitals would qualify for “essential health system” status by meeting one [...]

joe2024-02-20T17:02:55-05:00February 20, 2024|Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for February 1

The following is the latest health policy news from the federal government for January 26 – February 1. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has released its calendar year (CY) 2025 Advance Notice for the Medicare Advantage and Medicare Part D Prescription Drug Programs that would update payment and other policies for these programs. Under the notice, federal Medicare Advantage spending would increase an expected 3.7 percent, or more than $16 billion, but the agency also proposes reducing by 0.16 percent the program’s base rate. CMS also detailed [...]

joe2024-02-01T21:47:38-05:00February 1, 2024|Accountable Care Organization, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Federal Update, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for January 25

The following is the latest health policy news from the federal government for January 12 - 25. Some of the language used below is taken directly from government documents. Department of Health and Human Services – Funding Models HHS has announced a new model to test approaches for addressing the behavioral and physical health and health-related social needs of people with Medicaid and Medicare. The goal of the Innovation in Behavioral Health Model (IBH) is to improve the overall quality of care and outcomes for adults with mental health conditions and/or substance use disorders by connecting them with the physical, behavioral, [...]

joe2024-01-25T22:30:26-05:00January 25, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health, Telehealth|

Analysis Looks at Problems Plaguing Unwinding of Medicaid Continuous Eligibility

Since the end of the continuous Medicaid eligibility that was a major part of the Families First Coronavirus Response Act, more than 14 million Americans have lost their Medicaid eligibility. In a new analysis, KFF looks at the challenges both consumers and states have encountered in attempting to review the eligibility of the Medicaid population and to ensure that those who are no longer eligible can be directed to other options for health insurance. Among the factors addressed in this analysis are: State outreach to affected individuals, the effectiveness of those efforts, and the adjustments states have made along the [...]

joe2024-01-23T20:01:41-05:00January 24, 2024|hospitals, Medicaid|