Medicaid managed care

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 [...]

Federal Health Policy Update for September 12

The following is the latest health policy news from the federal government for September 6-12.  Some of the language used below is taken directly from government documents. 340B A federal court has declined to issue a preliminary order to block implementation of a Maryland law that requires pharmaceutical companies to provide discounts on drugs dispensed by eligible 340B providers by contract pharmacies.  The challenge to the Maryland law, filed by Pharmaceutical Research and Manufacturers of America (PhRMA) and several pharmaceutical companies, will be heard without a temporary order suspending the law’s implementation.  Learn more from the court order. Centers for [...]

Federal Health Policy Update for July 18

The following is the latest health policy news from the federal government for July 13-18.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has issued a notice alerting certain clinicians who are qualifying alternative payment model (APM) participants and who have earned an APM incentive payment that the agency does not have the current contact information it needs to disburse their payments.  The notice provides information to qualified participants on how to update their Medicare billing information so that CMS can disburse these payments.  Learn more from this CMS [...]

Federal Health Policy Update for May 30

The following is the latest health policy news from the federal government for May 24-30.  Some of the language used below is taken directly from government documents. Congress When the House and Senate return to Washington, DC from the Memorial Day recess next week committees will resume holding hearings and markups on health care policy while appropriators will focus on funding for federal fiscal year 2025, which begins October 1.  While there seems to be plenty of activity in Congress it is widely expected that only the most essential bills, like emergency supplemental packages and bills to keep the federal [...]

Federal Health Policy Update for May 23

The following is the latest health policy news from the federal government for May 18-23.  Some of the language used below is taken directly from government documents. Congress Leaders of the Senate Finance Committee have released a white paper outlining potential reforms of how Medicare pays physicians and how Medicare might better meet the needs of those with chronic illnesses.  The white paper notes areas of interest the committee sees as opportunities for reform, including: Creating sustainable payment updates to ensure clinicians can own and operate their practices. Creating incentives for alternative payment models that reward providing better care at [...]

Federal Health Policy Update for April 25

The following is the latest health policy news from the federal government for April 9-25.  Some of the language used below is taken directly from government documents. Updated 340B Arbitration Process Last week HHS’s Health Resources and Services Administration (HRSA) published a regulation modifying the administrative dispute resolution (ADR) process it uses to adjudicate payment disputes between 340B-eligible providers and pharmaceutical companies.  The major changes in the ADR process include the use of HRSA experts to serve on ADR panels; elimination of the $25,000 damage threshold for filing a claim; 340B-eligible providers may now challenge manufacturers that seek to prevent [...]

Federal Health Policy Update for March 21

The following is the latest health policy news from the federal government for March 15-21.  Some of the language used below is taken directly from government documents. The White House The White House has announced new actions to advance women’s health research and innovation and issued an executive order in support of that objective.  The order directs executive branch agencies to integrate women’s health across the federal research portfolio; prioritize investments in women’s health research; pursue new research on women’s midlife health; and assess unmet needs to support women’s health research.  Learn more from this White House fact sheet, which [...]

Federal Health Policy Update for December 20

The following is the latest health policy news from the federal government December 14-20.  Some of the language used below is taken directly from government documents. Congress The House is in recess until January 9.  The Senate has delayed its recess to continue negotiations on a possible foreign aid and border policy deal. Democrats from the House Ways and Means Committee have published a report on the relationship between the U.S. health care system and climate change.  View their report “Health Care and the Climate Crisis:  Preparing America’s Health Care Infrastructure.” No Surprises Act The federal government has reopened the [...]

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 meeting. MACPAC’s December 2023 meeting opened with a session that highlighted findings related to sexual orientation and gender identity (SOGI) data collection as part of the Commission’s focus on the collection of primary language and limited English proficiency, SOGI, and disability data for the purposes of assessing and addressing health disparities. During this discussion, we reviewed the purpose of SOGI data and federal and state priorities for collecting these data, which includes an overview of [...]

Federal Health Policy Update for December 14

The following is the latest health policy news from the federal government for December 8-14.  Some of the language used below is taken directly from government documents. MedPAC Rate Recommendations At their latest public meeting, members of the Medicare Payment Advisory Commission voted preliminary approval of the following rate updates for 2025 Medicare payments: Inpatient and outpatient services –update provided for in current law plus 1.5% and adoption of a safety-net index policy to pay safety-net hospitals another $4 billion. Physicians and other health professionals –update of 50% of the Medicare economic index and a new add-on payment for services [...]

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