Medicaid regulations

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 [...]

joe2024-07-18T20:57:21+00:00July 18, 2024|Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|

Federal Health Policy Update for July 12

The following is the latest health policy news from the federal government for July 6-12. Some of the language used below is taken directly from government documents. The Courts A federal court has blocked implementation of the FTC’s rule banning non-compete clauses in most employment contracts, a regulatory development with potentially significant implications for the health care industry. The temporary ban affects only the five plaintiffs in the case and it is not yet clear whether the ruling will have broader implications in the wake of the recent reversal of the Chevron decision that could potentially curtail the rulemaking authority [...]

joe2024-07-12T18:46:49+00:00July 12, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, hospitals, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Court’s Chevron Decision to Affect Health Care

A Supreme Court decision last week could have a profound effect on the regulation of many aspects of the health care industry. The Chevron decision, issued by the court in 1984, called for courts to defer to federal agency interpretation of ambiguous statutes if they found those interpretations to be reasonable. The latest Supreme Court ruling, however, overturns that approach, calling for the courts to act independently when evaluating the appropriateness of agency interpretations and the regulations federal agencies implement in support of those interpretations. The Washington Post explains that Legal experts and health officials expect a gusher of litigation [...]

joe2024-07-02T17:26:48+00:00July 2, 2024|Medicaid, Medicaid regulations, Medicare, Medicare regulations|

Federal Health Policy Update for June 13

The following is the latest health policy news from the federal government for June 7-13. Some of the language used below is taken directly from government document. Supreme Court The Supreme Court has agreed to hear a challenge to how the Department of Health and Human Services calculates hospitals’ Medicare disproportionate share (Medicare DSH) payments. The case was added to the court’s 2024-2025 schedule. Congress Individual members and key committees in Congress continue to introduce and mark up health care-related legislation with an eye toward including these initiatives in an end-of-year package. This work is expected to continue through the [...]

joe2024-06-13T20:15:06+00:00June 13, 2024|Alternative payment models, Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

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 [...]

joe2024-05-23T18:28:33+00:00May 23, 2024|340b, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for May 17

The following is the latest health policy news from the federal government for May 10-17. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced a further extension of deadlines for fulfilling certain Medicaid unwinding requirements. Some current deadlines will be extended to December 31, 2024 and others through June 30, 2025. States also may seek to extend selected COVID-19-related flexibilities through June 30, 2025. Among the deadlines affected by this announcement are those for using ex parte information to determine eligibility; permitting Medicaid managed care organizations to help [...]

joe2024-05-17T20:18:34+00:00May 17, 2024|Centers for Medicare & Medicaid Services, health equity, hospitals, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, social determinants of health|

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 [...]

joe2024-04-25T20:25:44+00:00April 25, 2024|340b, Accountable Care Organization, ACO, Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid long-term services and supports, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care, Medicaid regulations for the disabled, Medicare, Medicare post-acute care, Medicare regulations, post-acute care|

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 April 2024 Commission meeting began with a presentation of a draft chapter on demographic data collection in Medicaid for the June Report to Congress. Racial and ethnic health disparities persist throughout the U.S. health care system. Previous meetings have focused on the collection of primary language and limited English proficiency, sexual orientation and gender identity (SOGI), and disability data to help assess and address these health disparities. Measuring differences in access and use of [...]

joe2024-04-16T17:34:59+00:00April 17, 2024|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid long-term services and supports, Medicaid regulations|

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 March 2024 MACPAC meeting began with proposed recommendations on improving the transparency of Medicaid financing. The proposed recommendations are intended to improve the transparency of Medicaid financing methods, state-level financing amounts, and provider-level financing amounts. The presentation also included a recommendation to apply the proposed Medicaid financing transparency requirements to the State Children’s Health Insurance Program (CHIP). Staff reviewed the rationale for the recommendations and the implications for various stakeholders. The Commission will vote on [...]

joe2024-03-13T16:48:07+00:00March 14, 2024|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicaid regulations for the disabled|

Federal Health Policy Update for March 7

The following is the latest health policy news from the federal government for March 1-7. Some of the language used below is taken directly from government documents. Congress On Wednesday, March 16 the House passed, by a vote of 339-85, the first package of spending bills to fund some federal agencies through the remainder of the 2024 federal fiscal year. The House bills include several health care provisions extending programs that were set to expire on Friday, March 8. The bills would extend the following provisions and programs through December 31, 2024: The continued delay of cuts to Medicaid disproportionate [...]

joe2024-03-07T21:42:53+00:00March 7, 2024|Alternative payment models, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|