Medicaid

Federal Health Policy Update for March 30

The following is the latest health policy news from the federal government for March 24-30. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS’s Center for Medicare and Medicaid Innovation (CMMI) has extended its Medicare Advantage Value-Based Insurance Design (VBID) Model for calendar years 2025 through 2030 and will introduce changes intended to address more fully the health-related social needs of patients, advance health equity, and improve care for patients with serious illness. Learn more from this CMS announcement, which includes a link to additional information about the program. CMS [...]

iqtsupport2023-03-30T17:20:37-04:00March 30, 2023|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, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for March 23

The following is the latest health policy news from the federal government for March 17-23. Some of the language used below is taken directly from government documents. No Surprises Act After a February ruling in federal court that aspects of CMS’s implementation of the 2020 No Surprises Act contradicted the language of the act itself and unfairly favored payers over providers, CMS ordered a moratorium on new arbitration decisions for disputes filed on or after October 25, 2022 while it reviewed and revised its guidance on how payment disputes should be decided. Now, CMS has completed that task and issued [...]

iqtsupport2023-03-23T16:11:42-04:00March 23, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare|

Federal Health Policy Update for March 16

The following is the latest health policy news from the federal government for March 13-16. Some of the language used below is taken directly from government documents. Medicare Payment Advisory Commission (MedPAC) MedPAC has published its “March 2023 Report to the Congress: Medicare Payment Policy.” In this year’s report MedPAC considers the context of the Medicare program, including the near-term consequences of COVID-19 and the longer-term effects of program spending on the federal budget and the program’s financial sustainability. It evaluates payment adequacy and make recommendations concerning Medicare payment policy in 2024 for selected fee-for-service payment systems but explains that [...]

iqtsupport2023-03-16T17:31:47-04:00March 16, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for Friday, March 10

The following is the latest health policy news from the federal government for March 6-10. Some of the language used below is taken directly from government documents. White House FY 2024 Budget Proposal The Biden administration this week released its proposed FY 2024 federal budget. Among its many proposals are measures to extend the life of the Medicare hospital trust fund and reduce Medicare beneficiaries’ health care costs; to reduce prescription drug costs for consumers, Medicare, and Medicaid; to return high Medicaid managed care organization profits to the federal government; to make behavioral health care more affordable for seniors; to [...]

iqtsupport2023-03-10T15:57:42-05:00March 10, 2023|340b, Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The March 2023 MACPAC meeting began with a staff presentation on potential recommendations for countercyclical disproportionate share hospital (DSH) allotments. Medicaid DSH payments offset hospital uncompensated care costs for Medicaid-enrolled and uninsured patients. During economic recessions, Medicaid enrollment and the number of people who are uninsured increases. During the October 2022 MACPAC meeting, Commissioners agreed that a countercyclical policy should be implemented during future economic recessions, and asked for additional analyses of the effects [...]

iqtsupport2023-03-10T06:00:08-05:00March 10, 2023|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations for long-term care|

Federal Health Policy Update for March 3

The following is the latest health policy news from the federal government for February 27 to March 3. Some of the language used below is taken directly from government documents. No Surprises Act The Independent Dispute Resolution (IDR) entities empowered by the No Surprises Act to adjudicate disagreements between providers and payers may resume their work – but only some of it. CMS has directed IDRs entities to resume processing payment determinations on February 27 for disputes involving items or services furnished before October 25, 2022 but not to issue decisions involving items or services furnished on or after October [...]

iqtsupport2023-03-03T13:20:02-05:00March 3, 2023|Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, MedPAC, Telehealth|

Medicaid Programs See Roadmap for Unwinding

With the end of the COVID-19 pandemic’s continuous Medicaid eligibility coming on April 1, the states now face the challenge of reviewing the eligibility of 90 million people currently on the nation’s Medicaid rolls. The process, commonly referred to as “Medicaid unwinding,” promises to be challenging to states and current Medicaid participants. While the federal government has provided considerable guidance on how Medicaid unwinding should proceed, the National Association of Medicaid Directors has ideas of its own that it has presented on the organization’s blog. Specifically, the group suggests to its members a three-part approach to tackling Medicaid unwinding. Phase [...]

iqtsupport2023-03-02T06:00:28-05:00March 2, 2023|Medicaid|

The Emergence of “Food as Medicine”

In both the public and private sectors, a growing movement is working to integrate food as part of medical treatment – and have health care payers foot the bill. From the administration’s granting of Medicaid waivers to Arkansas, Massachusetts, and Oregon to use state and federal money to pay for food for some beneficiaries to Congress tucking $2 million into an appropriations bill for a “food is medicine pilot program” to the NIH developing a $140 million grant program that will lead to the designation of “food is medicine centers of excellence,” providers and policy-makers are showing unprecedented interest in [...]

iqtsupport2023-02-27T06:00:08-05:00February 27, 2023|health equity, Medicaid, Medicare, social determinants of health|

Federal Health Policy Update for February 23

The following is the latest health policy news from the federal government for February 17-23. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has issued an informational bulletin to states reiterating certain federal requirements that pertain to health care-related taxes. Recently, CMS became aware that some health care-related tax programs appear to involve agreements among providers to redistribute their Medicaid payments to hold taxpayers harmless for the cost of the tax. The bulletin reminds states that such arrangements are prohibited. Find the CMS bulletin here. CMS has posted a [...]

iqtsupport2023-02-23T15:53:32-05:00February 23, 2023|Accountable Care Organization, ACO, Alternative payment models, COVID-19, Medicaid, Medicare, Telehealth|

Most Medicaid Participants Don’t Know About Looming Eligibility Redetermination

With the COVID-19 pandemic’s continuous Medicaid eligibility set to expire in a little more than a month, nearly two-thirds of the current Medicaid population is unaware their continued participation in the program will soon be subject to review and could result in their loss of health care benefits. According to a survey conducted for the Robert Wood Johnson Foundation, “In December 2022, more than 6 in 10 adults in Medicaid-enrolled families were not aware of an upcoming return to the regular Medicaid renewal processes…” This could pose a major challenge both for those who lose their Medicaid coverage and may [...]

iqtsupport2023-02-23T06:00:41-05:00February 23, 2023|Medicaid|