Medicaid

Federal Health Policy Update for September 3

Don’t Miss: 340B data reporting requirements for Medicare Part D claims data – repository opens October 1 CMS permanently permits providers to deliver telehealth from home without listing home address on Medicare enrollment application The following is the latest health policy news from the federal government for August 28-September 3. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services (CMS) CMS is preparing to launch a new Medicare Part D Claims Data 340B Repository on October 1. The 340B data repository will be a centralized, federally managed information system that will [...]

joe2026-09-03T17:26:34-04:00September 3, 2026|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, hospitals, Medicaid, Medicare, Medicare regulations, MedPAC, Telehealth|

With Medicaid Enrollment Down, More Patients Paying Cash

With roughly five million Americans losing their Medicaid coverage since early 2025 as a result of the expiration of COVID-inspired eligibility expansions and the introduction of new, more stringent eligibility criteria, more people, faced with the need for health care and without their Medicaid safety net, are turning to cash to pay for the services they need. According to new data, 7.6 percent of ER patients paid cash in the second quarter of 2026, up from 5.5 percent in 2022. Meanwhile, the number of cash-paying, uninsured inpatients rose from 1.9 percent to 2.6 percent over the same period of time. [...]

joe2026-09-01T15:54:46-04:00September 2, 2026|hospitals, Medicaid|

Prior Authorization Remains a Challenge

Getting timely prior authorization for needed medical care continues to pose a problem for patients and providers. Despite federal government action to address prior authorization concerns associated with health care programs it oversees – Medicare Advantage, Medicaid and CHIP fee-for-service and managed care plans, and Affordable Care Act Marketplace plans – and the insistence of some insurers that they have been addressing the issue, problems persist. According to a recent analysis by KFF (quoted directly): Medicare Advantage insurers denied 12% of standard prior authorization requests, Medicaid managed care insurers denied 14%, and ACA Marketplace insurers denied 18%. Denial rates for [...]

joe2026-08-27T16:21:27-04:00September 1, 2026|Affordable Care Act, Medicaid, Medicaid managed care, Medicare|

Federal Health Policy Update for August 27

Don’t Miss: Homeland Security proposes new six-figure H-1B visa fee CMS announces refinement of critical access hospital status evaluation HHS seeks feedback on relative of childhood vaccines The following is the latest health policy news from the federal government for August 21-27. Some of the language used below is taken directly from government documents. Congress The House will return from recess next Monday, August 31 and the Senate returns on September 14. Funding for the federal government expires after September 30. H-1B Visas The Department of Homeland Security has issued a notice of proposed rulemaking calling for a $103,265 fee [...]

joe2026-08-27T16:40:49-04:00August 27, 2026|Centers for Medicare & Medicaid Services, Medicaid, Medicare, Medicare reimbursement policy, MedPAC|

The Implications of New Limits on Medicaid Provider Taxes

Last year’s federal budget reconciliation law, in addition to introducing nearly a trillion dollars in federal health care spending cuts over the next decade, took aim at a tool state governments consider vital in financing their Medicaid programs: provider taxes. For years, states have used provider taxes, typically on some aspect of hospital activity, to help finance their share of their Medicaid programs; currently, 49 of the 50 states have such taxes. Among other benefits, using provider taxes in this manner has enabled states to avoid using more general fund money for this purpose. But the 2025 law imposes new [...]

joe2026-08-25T13:45:21-04:00August 26, 2026|Medicaid, Medicaid regulations|

Infants, Toddlers Increasingly Dependent on Public Health Insurance

A new study highlights the growing dependence of families on public health insurance programs – Medicaid and the Children’s Health Insurance Program – to pay for care for their infants and children. According to a new analysis by the Georgetown University McCourt School for Public Policy, Medicaid and the Children’s Health Insurance Program (CHIP) cover 4 in 10 (39.7%) children under age 3. For families earning less than 200% of the federal poverty level—about $54,640 for a family of three—Medicaid and CHIP are even more critical sources of coverage, insuring approximately three-quarters (74.6%) of infants and toddlers. Other major findings, [...]

joe2026-08-20T15:52:49-04:00August 24, 2026|Medicaid|

Federal Health Policy Update for August 20

Don’t Miss: Latest No Surprises Act/Independent Dispute Resolution news Dept of Homeland Security issues guidance on “public charge” The following is the latest health policy news from the federal government for August 14-20. Some of the language used below is taken directly from government documents. Congress Thirty Senate Democrats have written to HHS Secretary Kennedy seeking to reverse the cancellation of health research grants administered by the Agency for Healthcare Research and Quality (AHRQ). For more information, see the letter here. Congress remains in recess; the House is expected to return on August 31 and the Senate on September 14. [...]

joe2026-08-20T15:55:42-04:00August 20, 2026|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Non-Profit Hospitals Struggled in 2025, Moody’s Finds

The financial performance of non-profit hospitals weakened in 2025, according to Moody’s, the financial rating service company. According to Moody’s: Median operating margins fell from 1.3 percent in 2024 to 1.2 percent in 2025. Median operating income fell 13.3 percent. Revenue growth fell from 9.6 percent to 8.9 percent. Expenses continued to grow, driven by increased wages and rising costs for purchased services and prescription drugs. On the other hand, Moody’s also found that: Revenue growth outpaced rising expenses. Patient and pharmacy activity grew. Hospitals in some states benefited from expanded Medicaid supplemental payments. Commercial reimbursement improved. For a closer [...]

joe2026-08-18T14:42:20-04:00August 20, 2026|hospitals, Medicaid|

Analysis Puts Price Tag on Loss of Medicaid State Directed Payments

Thirty-seven states face the loss of significant federal Medicaid revenue depending on how the Centers for Medicare & Medicaid Services ultimately implements a provision in the 2025 reconciliation bill that called for new limits on so-called state directed payments – Medicaid money the states direct to their Medicaid managed care plans with instructions on how to use that money. The 2025 law calls for nearly a trillion dollars in reduced federal Medicaid spending and $60 billion of that cut could result from new limits on state directed Medicaid payments to managed care organizations. Providers in eight states, led by California, [...]

joe2026-08-18T16:49:35-04:00August 19, 2026|Congress, hospitals, Medicaid|

Federal Health Policy Update for August 13

Don’t Miss: Federal court vacates key aspect of No Surprises Act’s IDR process President calls for changes in childhood immunizations CMS seeks billing info so it can pay APM docs their bonuses The following is the latest health policy news from the federal government for August 7-13. Some of the language used below is taken directly from government documents. The White House The White House has issued an executive order calling for a change in recommended childhood vaccines. The order suggests reducing the number of recommended childhood vaccines from the current 17 to 11 revising the status of the remaining [...]

joe2026-08-13T14:39:23-04:00August 13, 2026|Alternative payment models, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|