Medicaid regulations

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|
Read More

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 [...]

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

Executive Order Seeks to Reduce Federal Regulations

A new executive order issued by the Trump administration calls for a significant reduction in federal regulations. Describing many current federal regulations as overly complex, burdensome, and obstacles to economic growth and innovation, the order directs that Unless prohibited by law, whenever an executive department or agency (agency) publicly proposes for notice and comment or otherwise promulgates a new regulation, it shall identify at least 10 existing regulations to be repealed. The executive order also states that For fiscal year 2025, which is in progress, the heads of all agencies are directed to ensure that the total incremental cost of [...]

2025-02-04T16:06:30-05:00February 5, 2025|Medicaid regulations, Medicare regulations, Uncategorized|
Read More

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|
Read More

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|
Read More

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|
Read More

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 [...]

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

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|
Read More

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 [...]

2024-09-26T16:49:25-04:00September 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|
Read More

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 [...]

2024-09-12T15:22:15-04:00September 12, 2024|340b, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicare regulations, Medicare reimbursement policy, MedPAC|
Read More

© 2023 DeBrunner & Associates, All Rights Reserved.

Go to Top