Medicaid and CHIP Payment and Access Commission

Federal Health Policy Update for March 30

The following is the latest health policy news from the federal government for March 24-30. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS’s Center for Medicare and Medicaid Innovation (CMMI) has extended its Medicare Advantage Value-Based Insurance Design (VBID) Model for calendar years 2025 through 2030 and will introduce changes intended to address more fully the health-related social needs of patients, advance health equity, and improve care for patients with serious illness. Learn more from this CMS announcement, which includes a link to additional information about the program. CMS [...]

iqtsupport2023-03-30T17:20:37-04:00March 30, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for March 23

The following is the latest health policy news from the federal government for March 17-23. Some of the language used below is taken directly from government documents. No Surprises Act After a February ruling in federal court that aspects of CMS’s implementation of the 2020 No Surprises Act contradicted the language of the act itself and unfairly favored payers over providers, CMS ordered a moratorium on new arbitration decisions for disputes filed on or after October 25, 2022 while it reviewed and revised its guidance on how payment disputes should be decided. Now, CMS has completed that task and issued [...]

iqtsupport2023-03-23T16:11:42-04:00March 23, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare|

MACPAC Reports to Congress

The Medicaid and CHIP Payment and Access Commission has issued its annual report to Congress on the state of Medicaid and the Children’s Health Insurance Program. The commission, a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the Department of Health and Human Services, and the states on a wide array of subjects, issues a report every year at this time. This year’s report focuses primarily on: Medicaid race and ethnicity data collection and reporting principles for assessing Medicaid nursing facility payment programs strengthening evidence under Medicaid drug coverage MACPAC’s [...]

iqtsupport2023-03-23T06:00:58-04:00March 23, 2023|Congress, hospitals, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

Federal Health Policy Update for March 16

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. Medicare Payment Advisory Commission (MedPAC) MedPAC has published its “March 2023 Report to the Congress: Medicare Payment Policy.” In this year’s report MedPAC considers the context of the Medicare program, including the near-term consequences of COVID-19 and the longer-term effects of program spending on the federal budget and the program’s financial sustainability. It evaluates payment adequacy and make recommendations concerning Medicare payment policy in 2024 for selected fee-for-service payment systems but explains that [...]

iqtsupport2023-03-16T17:31:47-04:00March 16, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for Friday, March 10

The following is the latest health policy news from the federal government for March 6-10. Some of the language used below is taken directly from government documents. White House FY 2024 Budget Proposal The Biden administration this week released its proposed FY 2024 federal budget. Among its many proposals are measures to extend the life of the Medicare hospital trust fund and reduce Medicare beneficiaries’ health care costs; to reduce prescription drug costs for consumers, Medicare, and Medicaid; to return high Medicaid managed care organization profits to the federal government; to make behavioral health care more affordable for seniors; to [...]

iqtsupport2023-03-10T15:57:42-05:00March 10, 2023|340b, Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The March 2023 MACPAC meeting began with a staff presentation on potential recommendations for countercyclical disproportionate share hospital (DSH) allotments. Medicaid DSH payments offset hospital uncompensated care costs for Medicaid-enrolled and uninsured patients. During economic recessions, Medicaid enrollment and the number of people who are uninsured increases. During the October 2022 MACPAC meeting, Commissioners agreed that a countercyclical policy should be implemented during future economic recessions, and asked for additional analyses of the effects [...]

iqtsupport2023-03-10T06:00:08-05:00March 10, 2023|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations for long-term care|

Federal Health Policy Update for February 16

The following is the latest health policy news from the federal government for February 6-16. Some of the language used below is taken directly from government documents. No Surprises Act A federal judge in Texas has vacated parts of a regulation governing the arbitration process that is a major aspect of implementation of the No Surprises Act. In his ruling, the judge found that the arbitration process unfairly favored payers over providers, most notably by placing undue emphasis on the qualified payment amount (QPA) that is a major part of the arbitration process. The decision explains that “The Court first [...]

iqtsupport2023-02-16T17:02:31-05:00February 16, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations|

Federal Health Policy Update for February 6

The following is the latest health policy news from the federal government for the week of January 23 to February 6. Some of the language used below is taken directly from government documents. 340B Pharmaceutical companies may restrict the ability of providers to use specialty and community pharmacies to distribute 340B-covered drugs, a federal appeals court has decided. See the court’s ruling here. Centers for Medicare & Medicaid Services CMS has revised its fact sheets about COVID-19 public health emergency waivers and flexibilities for different types of providers, updating which waivers and flexibilities have already been terminated, which have been [...]

iqtsupport2023-02-06T17:03:31-05:00February 6, 2023|340b, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for January 20

The following is the latest health policy news from the federal government for the week of January 13-20. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published updates to the Healthcare Common Procedure Coding System (HCPCS) codes on the Required Face-to-Face Encounter and Written Order Prior to Delivery List. The update adds ten codes to the list of items that require a face-to-face encounter between provider and patient and a written order prior to delivery as a condition of payment. Go here for a summary of the update [...]

iqtsupport2023-01-20T15:28:07-05:00January 20, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for January 5

The following is the latest health policy news from the federal government for December 23 through January 5. Some of the language used below is taken directly from government documents. No Surprises Act HHS, the Department of Labor, and the Department of the Treasury have announced increases in the administrative fee for initiating the No Surprises Act’s Independent Dispute Resolution (IDR) process and for certified IDR entities. Learn more about the administrative fee change here and about the certified IDR entity fee change here. Both changes took effect on January 1. HHS, the Department of Labor, and the Department of the [...]

iqtsupport2023-01-05T17:15:07-05:00January 5, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|