MACPAC

Federal Health Policy Update for February 13

The following is the latest health policy news from the federal government for February 7 - 13.  Some of the language used below is taken directly from government documents. Introduction With the pause in external communication that the new administration imposed on HHS three weeks ago, including announcements, advisories, regular publications, and web site updates, there has been very little public communication from or activity involving HHS in the past week.  While an HHS spokesperson explained that the moratorium has been eased and agencies are now permitted to engage in some public communication, subject to review, such activity remains very [...]

2025-02-13T15:23:17-05:00February 13, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|
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Federal Health Policy Update for January 23

The Administration Public Communication The new administration has directed HHS to pause all external communications, including announcements, advisories, regular publications, and web site updates.  According to a published report, "HHS has issued a pause on mass communications and public appearances that are not directly related to emergencies or critical to preserving health," a spokesperson wrote in an email.  "This is a short pause to allow the new team to set up a process for review and prioritization.  There are exceptions for announcements that HHS divisions believe are mission critical, but they will be made on a case-by-case basis."  The directive [...]

2025-01-23T14:37:57-05:00January 23, 2025|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, COVID-19, Federal Update, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare bad debt reimbursement, Medicare cuts, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Pennsylvania Update|
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Federal Health Policy Update for January 16

The following is the latest health policy news from the federal government for January 11-17.  Some of the language used below is taken directly from government documents. Congress   House Budget Committee Republican members of the House Budget Committee have circulated a list of possible policy changes that would reduce federal spending by between $5.3 trillion and $5.7 trillion over a period of ten years.  Up to $3.4 trillion of those possible cuts could include reductions in federal health care spending.  The health care cuts the document lists (all figures are ten-year reductions) are: Medicare introducing Medicare site-neutral outpatient payments - [...]

2025-01-16T16:45:18-05:00January 16, 2025|Accountable Care Organization, ACO, Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, Federal Update, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare bad debt reimbursement, Medicare cuts, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, Pennsylvania Update, Telehealth|
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Federal Health Policy Update for December 19

The following is the latest health policy news from the federal government for December 13-19.  Some of the language used below is taken directly from government documents. Congress Funding for the operation of the federal government will expire tomorrow, December 20, unless Congress passes a funding bill.  Earlier this week, congressional leaders agreed on a continuing resolution that included a number of health care priorities, including relief from scheduled Medicaid DSH cuts, relief for Medicare physician payment cuts, extension of telehealth flexibilities, extension of the Acute Hospital Care at Home program, a number of changes in the practices of pharmacy [...]

2024-12-19T16:06:57-05:00December 19, 2024|340b, Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare reimbursement policy, MedPAC, Telehealth|
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MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met publicly last week in Washington, D.C. The following is MACPAC’s own summary of its meeting. The MACPAC December 2024 meeting began with a discussion on accountability in Medicaid managed care, which is the predominant delivery system in Medicaid. MACPAC will examine the tools the Centers for Medicare & Medicaid Services (CMS) and state Medicaid agencies use to manage managed care organizations’ (MCOs) performance and hold plans accountable to contractual obligations. Staff presented findings from MACPAC’s review of federal policy and a 40-state review of accountability tools as described in [...]

2024-12-17T15:23:53-05:00December 18, 2024|Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations|
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Federal Health Policy Update for December 5

The following is the latest health policy news from the federal government for November 22 – December 5.  Some of the language used below is taken directly from government documents. Congress The House has posted its session calendar for 2025.  Find that calendar here. Yesterday, House Republicans made an offer to House Democrats regarding health care provisions to be included in the continuing resolution (CR) that must pass before December 20.  The offer is a conversation-opener and very few details are available.  Although most of the proposed policies have bipartisan support, there are some tangible policy differences, including House Democrats’ [...]

2024-12-05T17:14:33-05:00December 5, 2024|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Federal Update, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Pennsylvania Update|
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Federal Health Policy Update for November 7

The following is the latest health policy news from the federal government for November 1-7.  Some of the language used below is taken directly from government documents. Medicare Payment Regulations Late last week CMS published four regulations describing how Medicare will pay certain providers in 2025.  The following is a brief overview of those regulations. Medicare Outpatient Prospective Payment System Rate increase of 2.9 percent for outpatient and ambulatory surgical center services. New Conditions of Participation for obstetrical services. Additional payments for selected non-opioid treatments for pain relief. Minor modifications of the inpatient-only list. A change in the review time [...]

2024-11-07T16:26:47-05:00November 7, 2024|Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|
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Federal Health Policy Update for October 31

The following is the latest health policy news from the federal government for October 25-31.  Some of the language used below is taken directly from government documents. The White House The White House has announced a new private sector pilot program to maintain uninterrupted access to seven pre-selected pediatric cancer medications.  Pilot participants in this program, which is part of the Biden Cancer Moonshot, will develop stewardship standards focused on identifying shortage risks, promoting transparent inventory awareness, and fostering an effective approach to preventing patient care disruptions and maintaining consistent drug distribution to children and families facing cancer.  The pilot [...]

2024-10-31T15:10:55-04:00October 31, 2024|Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare regulations, Medicare reimbursement policy, Telehealth|
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Federal Health Policy Update for August 30

The following is the latest health policy news from the federal government for August 23-30.  Some of the language used below is taken directly from government documents. 340B Johnson & Johnson, the pharmaceutical, biotechnology, and medical technologies company, told health care providers this week that it would shift from the long-time 340B upfront discount approach to a rebate model for two of its drugs and that eligible 340B hospitals and other providers will need to purchase the prescription drugs Stelara and Xarelto at list price and then, after dispensing them to patients, will need to submit 340B rebate claims to [...]

2024-08-30T15:03:18-04:00August 30, 2024|340b, Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid long-term services and supports, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|
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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 [...]

2024-08-22T15:11:48-04:00August 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|
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