Medicaid

Federal Health Policy Update for June 20

The following is the latest health policy news from the federal government for June 14-20.  Some of the language used below is taken directly from government documents. No Surprises Act HHS and the departments of Labor and the Treasury have announced a policy that offers extra time to health care providers whose desire to engage in No Surprises Act adjudication of payment disagreements with payers was affected by the Change Healthcare cybersecurity attack.  Under this temporary policy,  providers, facilities, and providers of air ambulance services whose ability to initiate timely No Surprises Act open negotiation for any item or service [...]

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 [...]

Federal Health Policy Update for June 6

The following is the latest health policy news from the federal government for May 31-June 6.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services The deadline for stakeholders to submit comments on CMS’s proposed FY 2025 Medicare inpatient prospective payment system and long-term-care hospital prospective payment system regulation is Monday, June 10.  Go here for further information about the proposed rule and how to submit comments. CMS has posted a bulletin describing billing changes in the Medicare hospital outpatient prospective payment system that will take effect on July 1.  Find [...]

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 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 [...]

Medicaid Unwinding Extended

The federal government is giving states more time to complete their Medicaid unwinding process – and people still on the Medicaid rolls more time to apply to retain their Medicaid eligibility. In a memo to state Medicaid programs, the Centers for Medicare & Medicaid Services wrote that To continue supporting states’ efforts to establish and update income and eligibility determination systems that maximize states’ ability to ensure that eligible individuals retain coverage, CMS is further extending these unwinding-related…waivers through June 30, 2025. When the Families First Coronavirus Response Act’s prohibition against removing people from state Medicaid rolls ended with the [...]

2024-05-15T17:07:11+00:00May 15, 2024|COVID-19, Medicaid|

Federal Health Policy Update for May 9

The following is the latest health policy news from the federal government for May 3-9.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services HHS and CMS have announced the Increasing Organ Transplant Access Model, which seeks to increase access to kidney transplants for people living with end-stage renal disease (ESRD), improve the quality of care for people seeking kidney transplants, reduce disparities among individuals undergoing the process of receiving a kidney transplant, and increase the efficiency and capability of transplant hospitals selected to participate.  Hospitals eligible to be selected for [...]

Federal Health Policy Update for May 2

The following is the latest health policy news from the federal government for April 26 – May 2.  Some of the language used below is taken directly from government documents. No Surprises Act – Independent Dispute Resolution Process CMS has announced a new process for resubmitting Independent Dispute Resolution (IDR) disputes that were originally improperly batched or bundled.This new resubmission process is automated in the federal IDR portal and seeks to streamline federal IDR operations.  For further information about this new process and an implementation timetable, see this CMS announcement.  CMS also has posted a user guide for the IDR [...]

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 [...]

Go to Top