Medicaid and CHIP Payment and Access Commission

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 [...]

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 [...]

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 [...]

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15.  Some of the language used below is taken directly from government documents. White House The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans.  Learn more about the plan from this White House fact sheet and go here for a transcript of the White House [...]

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 December 2022 MACPAC meeting began with a Commission discussion on two potential recommendations for improving Medicaid race and ethnicity data reporting. As part of its commitment to prioritizing health equity in all of its work, the Commission is focused on how to improve Medicaid race and ethnicity data collection and reporting. In October, staff presented findings from a literature review and key stakeholder interviews, as well as possible approaches for improving the collection [...]

FEDERAL HEALTH POLICY UPDATE FOR December 1

The following is the latest health policy news from the federal government for the week of November 28 to December 1.  Some of the language used below is taken directly from government documents. 340B HHS and its Health Resources and Services Administration (HRSA) have proposed revising the current 340B administrative dispute resolution process.  Since the current process was introduced in 2020 HRSA has encountered policy and operational challenges with its implementation and now proposes revising it and is soliciting comment on its proposed new approach.  Changes include changing the nature of the dispute resolution process, using different kinds of professionals [...]

Federal Health Policy Update for November 10

The following is the latest health policy news from the federal government for the week of November 7 to 10.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published a notice advising teaching hospitals that they have until November 18 to ask Medicare to reconsider their per resident amounts or resident caps as shown in the Hospital Cost Report Information System (HCRIS) associated with cost reports that, as of July 1, 2022, were not reopenable.  Learn more from this CMS notice. Due to an unplanned system outage of [...]

FEDERAL HEALTH POLICY UPDATE FOR November 3

The following is the latest health policy news from the federal government for the week of October 31 to November 3.  Some of the language used below is taken directly from government documents. Medicare Payment Regulations In the past week CMS has published four regulations presenting how it will pay providers in the coming year. Outpatient prospective payment system – CMS announced a 3.8 percent increase for Medicare outpatient and ambulatory surgical payments.  It also adopted its proposal to establish rural emergency hospitals as a new kind of hospital provider; removed 11 surgical procedures from its inpatient-only list and authorized [...]

FEDERAL HEALTH POLICY UPDATE FOR OCTOBER 20

The following is the latest health policy news from the federal government for the week of October 14 to October 20.  Some of the language used below is taken directly from government documents. White House President Biden has signed an executive order on lowering prescription drug costs.  The order directs HHS to consider additional actions to further drive down prescription drug costs, encourages it to pursue such actions through its Center for Medicare and Medicaid Innovation (CMMI), and directs HHS to submit a formal report within 90 days outlining any plans to use CMMI’s authority to lower drug costs and [...]

FEDERAL HEALTH POLICY UPDATE FOR THE WEEK OF SEPTEMBER 19-27

The following is the latest health policy news from the federal government for the week of September 19-27.  Some of the language used below is taken directly from government documents. White House The White House has issued a fact sheet summarizing new actions and funding to address the overdose epidemic and support recovery as part of its September “National Recovery Month.” Awarding $1.5 billion for all states and territories to address addiction and the opioid crisis. Investing more than $104 million to expand substance use treatment and prevention in rural communities. Investing $20.5 million to increase access to recovery supports. [...]

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