Medicaid managed care

Federal Health Policy Update for May 22

The following is the latest health policy news from the federal government for May 16-22. Some of the language used below is taken directly from government documents. Congress: Reconciliation Early Thursday morning the House of Representatives passed its version of an FY 2025 budget reconciliation bill by a vote of 215-214. The bill underwent a number of changes during the hours before its passage and its health care provisions now include $800 billion in Medicaid cuts over the next ten years. The Congressional Budget Office projects that the bill, mostly because of the Medicaid cuts, will lead to 8.6 million [...]

joe2025-05-23T10:22:33-04:00May 23, 2025|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, COVID-19, deficit reduction, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for May 15

The following is the latest health policy news from the federal government for May 9-15. Some of the language used below is taken directly from government documents. Congress: Reconciliation House Energy and Commerce Committee Charged with finding $880 billion in federal spending cuts over the next ten years, the House Energy and Commerce Committee this week produced legislative language to be included in a House reconciliation bill that would achieve that objective. The committee’s cost-cutting provisions include: Freezing state Medicaid provider taxes at their current level, prohibiting the establishment of new provider taxes, modifying the criteria CMS uses to determine [...]

joe2025-05-15T17:19:56-04:00May 15, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, deficit reduction, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations, Medicare, Medicare cuts, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for May 8

The following is the latest health policy news from the federal government for May 2-8. Some of the language used below is taken directly from government documents. Congress Reconciliation Over the past several days the political gravity surrounding Medicaid cuts has begun to shift slightly. Moderate Republicans have been pushing back more forcefully and more loudly against such cuts, with some saying they will not support more than work requirements and increased enforcement checks for eligibility. Opposition to most Medicaid cuts led the Energy and Commerce Committee to delay a markup of its reconciliation bill planned for this week to [...]

joe2025-05-08T16:50:48-04:00May 8, 2025|Accountable Care Organization, Alternative payment models, Congress, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

Are Medicaid Provider Taxes, State-Directed Payments in Play?

Even as the House Energy and Commerce Committee contemplates how it will reach its assigned target of $880 billion in spending cuts mostly through Medicaid cuts, the Centers for Medicare & Medicaid Services may be following a similar course by targeting two potential changes that Congress is already thought to be considering: changes in policies governing Medicaid provider taxes and state-directed Medicaid payments. Recently, CMS filed a proposed regulation titled “Preserving Medicaid Funding for Vulnerable Populations – Closing a Health Care-Related Tax Loophole” to the Office of Management and Budget (OMB) for review. Speculation centers on whether this proposed policy [...]

joe2025-04-24T15:54:20-04:00April 28, 2025|Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations|

Federal Health Policy Update for April 24

The following is the latest health policy news from the federal government for April 18-24. Some of the language used below is taken directly from government documents. Congress The House and Senate are in recess until April 28. Upon their return to Washington D.C., committees will begin marking up reconciliation legislation for submission to their respective chambers’ budget committees by May 9. The Energy and Commerce Committee is expected to mark up its bill, with $880 billion in cuts, the week of May 5. The committee is expected to seek nearly $550 billion in cuts to Medicaid spending, with the [...]

joe2025-04-24T14:45:26-04:00April 24, 2025|340b, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicaid managed care, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for April 10

The following is the latest health policy news from the federal government for April 4-10. Some of the language used below is taken directly from government documents. Congress The House today passed the budget resolution passed by the Senate last week. Passage of the same budget resolution by both chambers now enables Congress to begin work on a reconciliation bill to enact President Trump’s priorities on tax cuts, border security, and energy policies. Until this morning, more than a dozen Republican House members had opposed the Senate-passed budget resolution because they believed the Senate’s budget did not require enough spending [...]

joe2025-04-10T16:05:02-04:00April 10, 2025|Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

Hospitals Chart 2025 Public Policy Objectives

The hospital industry has an ambitious public policy agenda for 2025 – most of it involving defending the status quo against proposed changes. Hospitals’ advocacy in 2025 will focus on: Fighting off Medicaid cuts, work requirements, reductions in the federal Medicaid matching rate, eliminating scheduled cuts in Medicaid disproportionate share (Medicaid DSH) allotments to the states, and protecting state-directed Medicaid payments and the ability of states to raise Medicaid funding through provider taxes. Preventing a transition to site-neutral payments for Medicare-covered outpatient services. Ensuring the continuation of current section 340B prescription drug discount program practices. Preserving and even extending current [...]

joe2025-02-12T11:11:23-05:00February 13, 2025|340b, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for November 21

The following is the latest health policy news from the federal government for November 15-21. Some of the language used below is taken directly from government documents. The Incoming Administration President Trump has nominated Robert F. Kennedy, Jr. for Secretary of Health and Human Services and Dr. Mehmet Oz for Administrator of the Centers for Medicare & Medicaid Services (CMS). Both positions require confirmation by the Senate. Senators will start the process of confirming the President-elect’s cabinet nominees when the new Congress convenes in January. Congress Funding for the federal government will expire on December 20 and it is still [...]

joe2024-11-21T15:14:52-05:00November 21, 2024|Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

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 [...]

joe2024-10-31T15:10:55-04:00October 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|

Federal Health Policy Update for September 26

The following is the latest health policy news from the federal government for September 20-26. Some of the language used below is taken directly from government documents. Congress Yesterday, Congress passed a continuing resolution to fund the federal government when the new federal fiscal year begins on October 1. The continuing resolution will extend funding for federal agencies at current levels through December 20 of this year. The bill did not include other significant policy provisions. President Biden will sign the bill this week and avoid a shutdown of the federal government. Find the bill text here. Following passage of [...]

joe2024-09-26T16:49:25-04:00September 26, 2024|Accountable Care Organization, ACO, Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|