Medicaid regulations

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met recently in Washington, D.C. The following is MACPAC’s own summary of its two days of public meetings. MACPAC’s September 2025 meeting began with a summary of Public Law 119-21, an Act to Provide for Reconciliation Pursuant to Title II of H. Con. Res. 14 (2025 Budget Reconciliation Act, P.L. 119-21). This legislation included several provisions affecting Medicaid and the State Children’s Health Insurance Program (CHIP). In this session, staff provided a summary of the Medicaid and CHIP-related provisions in the 2025 Budget Reconciliation Act. Staff then presented on work [...]

joe2025-09-26T09:15:24-04:00September 29, 2025|Centers for Medicare & Medicaid Services, Congress, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations|

Federal Health Policy Update for September 25

The following is the latest health policy news from the federal government for September 19-25. Some of the language used below is taken directly from government documents. Federal Funding for Fiscal Year 2026 Telehealth and Acute Hospital Care at Home Program Flexibilities Many current telehealth flexibilities and authorization for the Acute Hospital Care at Home program will expire on September 30 unless Congress extends them. The following is CMS’s current guidance on these programs if they are not extended by September 30: The CMS Acute Hospital Care at Home web page advises stakeholders that The Acute Hospital Care at Home [...]

Federal Health Policy Update for September 18

The following is the latest health policy news from the federal government for September 12-18. Some of the language used below is taken directly from government documents. Congress Funding for the federal government expires on September 30. Members of Congress have not yet coalesced around a plan to fund the federal government when the new federal fiscal year begins on October 1, with House Republican and Democratic leaders releasing competing legislative texts for a short-term continuing resolution (CR). House Republicans have proposed a CR to last through November 21 with very few anomalies, or policy changes, outside of regular spending. [...]

joe2025-09-18T17:11:02-04:00September 18, 2025|340b, Affordable Care Act, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, post-acute care, Telehealth|

Federal Health Policy Update for July 31

The following is the latest health policy news from the federal government for July 25-31. Some of the language used below is taken directly from government documents. Congress The House recessed last week and the Senate is still in session. When Congress returns in September its top priority will be funding the federal government before the fiscal year ends on September 30, likely requiring a continuing resolution to avoid a shutdown. Several major health care programs and extenders are set to expire at the end of the fiscal year, including Medicaid DSH allotments, telehealth flexibilities, the Acute Hospital Care at [...]

joe2025-07-31T15:04:29-04:00July 31, 2025|340b, 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, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare reimbursement policy, Telehealth|

OBBB Implementation Timeline

DeBrunner & Associates has prepared a timeline presenting the timeline showing the stages through which the FY 2026 federal budget reconciliation bill (the “One Big Beautiful Bill”) will be implemented. Find it here.

joe2025-07-17T15:53:25-04:00July 21, 2025|Congress, Medicaid, Medicaid regulations, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for July 3

The following is the latest health policy news from the federal government for June 27 – July 3. Some of the language used below is taken directly from government documents. Congress/Budget Reconciliation After more than 36 hours of intense lobbying by the administration and House Republican leadership and an all-night legislative session that carried well into Thursday afternoon, the House approved the Senate-passed version of H.R. 1, the reconciliation bill, by a vote of 218-214. Voting was almost entirely along party lines, with all House Democrats voting against it and just two Republicans – Brian Fitzpatrick (PA) and Thomas Massie [...]

joe2025-07-03T16:02:05-04:00July 3, 2025|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

Health Care Implications of Senate Reconciliation Bill

On Tuesday the Senate passed an FY 2026 budget reconciliation bill by a vote of 51-50, with Vice President Vance casting the tie-breaking vote. The bill cuts $1 trillion in Medicaid spending and keeps most of the Medicaid provisions included in the version released by the Senate Finance Committee in mid-June. The bill passed by the Senate creates a fund for rural providers of $50 billion over five years. The major Medicaid provisions in the bill include: A freeze on the size of Medicaid provider taxes, phased down reductions of current taxes toward a new, lower limit for many states, [...]

joe2025-07-02T12:58:19-04:00July 3, 2025|hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare|

Federal Health Policy Update for June 19

The following is the latest health policy news from the federal government for June 13-19. Some of the language used below is taken directly from government documents. Congress The Senate Finance Committee The Senate Finance Committee has released its portion of the FY 2025 budget reconciliation bill. Major proposals include: A freeze on the size of Medicaid provider taxes, phased down reductions of current taxes toward a new, lower limit for many states, and new terms under which provider taxes can be approved. New limits on the use of Medicaid state directed payments so they eventually will not exceed 100 [...]

joe2025-06-19T16:17:10-04:00June 19, 2025|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare reimbursement policy|

Federal Health Policy Update for June 12

The following is the latest health policy news from the federal government for June 6-12. Some of the language used below is taken directly from government documents. Congress Republican senators continue to work on their version of a reconciliation bill with a goal of passage by July 4, although that deadline may slip. Some Senate committees have begun releasing their portions of the bill but the Finance Committee’s bill, with its tax and Medicaid provisions, has not yet been released. Among the majority party in the Senate, fault lines around the House-passed reconciliation bill remain around Medicaid provider taxes, state [...]

joe2025-06-12T16:32:26-04:00June 12, 2025|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Administration Targets State Directed Medicaid Payments

The White House has issued a presidential memorandum on “Eliminating Waste, Fraud, and Abuse in Medicaid” that cites Medicaid “state-directed payments” as a form of waste, fraud, and abuse. According to the memorandum, states use state directed payments to pay more than Medicare rates for some Medicaid-covered services – something the memorandum suggests is contrary to current practice because “…billable costs for such care were historically capped at the same level that healthcare providers could receive from Medicare.” This assertion comes despite a 2024 regulation that set the payment limit for state directed payments at the average commercial rate and [...]

joe2025-06-11T10:22:01-04:00June 11, 2025|Medicaid, Medicaid managed care, Medicaid regulations|