Medicaid

Federal Health Policy Update for December 8

The following is the latest health policy news from the federal government for the week of December 4-8. Some of the language used below is taken directly from government documents. No Surprises Act CMS has published an FAQ about implementation of good faith estimates for uninsured and self-pay patients under the No Surprises Act. In the FAQ the agency explains that it will extend enforcement discretion for situations in which good faith estimates do not include expected charges from co-providers or co-facilities. This enforcement discretion was expected to end on January 1 but CMS now writes that it will remain [...]

iqtsupport2022-12-08T17:09:11-05:00December 8, 2022|Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid regulations, Medicare, Medicare bad debt reimbursement, Medicare cuts, Medicare regulations, Medicare reimbursement policy, Telehealth|

Before Recess, Congress Contemplates Medicaid

Before the current session of Congress comes to a close, lawmakers may consider a number of Medicaid issues. Among them: The future of Medicaid eligibility for those who enrolled in the program as a result of special provisions introduced in response to COVID-19. The process for reviewing the future eligibility of those currently enrolled in Medicaid. A movement to extend the current, temporary 12 months of postpartum Medicaid eligibility for new mothers and their newborns beyond the end of the current public health emergency. A gradual phasing out of the enhanced federal Medicaid matching funds states currently receive. Learn more [...]

iqtsupport2022-12-07T06:00:25-05:00December 7, 2022|Congress, Medicaid|

FEDERAL HEALTH POLICY UPDATE FOR December 1

The following is the latest health policy news from the federal government for the week of November 28 to December 1. Some of the language used below is taken directly from government documents. 340B HHS and its Health Resources and Services Administration (HRSA) have proposed revising the current 340B administrative dispute resolution process. Since the current process was introduced in 2020 HRSA has encountered policy and operational challenges with its implementation and now proposes revising it and is soliciting comment on its proposed new approach. Changes include changing the nature of the dispute resolution process, using different kinds of professionals [...]

States Seek Certainty on End of PHE

The country’s states want a clearer idea of when the official COVID-19 public health emergency will end – and along with it, the continuous Medicaid eligibility that remains a major component of the federal attempt to ensure health care coverage for millions of Americans during the pandemic. Even though two administrations have now regularly renewed the PHE for three-month periods and the current administration has promised governors 60 days’ notice of when the PHE will end, the nation’s Medicaid directors have written to congressional leaders asking for Congress to “…provide states with certainty around the end of the Medicaid continuous [...]

iqtsupport2022-11-30T06:00:58-05:00November 30, 2022|COVID-19, Medicaid|

Federal Health Policy Update for November 17

The following is the latest health policy news from the federal government for the week of November 11 to 17. Some of the language used below is taken directly from government documents. Provider Relief Fund Providers that cited extenuating circumstances for failing to submit Provider Relief Fund financial reports on time for reporting period 3 and were approved to submit their reports late must submit those late reports by December 2. Learn more here. Centers for Medicare & Medicaid Services CMS has posted three downloadable sample formats that hospitals can use to meet federal requirements for posting in a machine-readable [...]

iqtsupport2022-11-17T17:29:00-05:00November 17, 2022|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Medicaid, Medicare, Telehealth|

Medicaid and Children’s Behavioral Health

In response to the growing behavioral health challenges children face, including the need for inpatient hospitalization, the country’s Medicaid directors recently addressed the question of how Medicaid can best help tackle this challenge. The directors thought their programs could be most helpful in three ways: preventing crises by providing care and supports improving specialized inpatient psychiatric care supporting the return of patients to the community Learn more about how the Medicaid directors think this can be done and what some of them already are doing in the National Association of Medicaid Directors blog article “How Medicaid is Making a Difference [...]

iqtsupport2022-11-15T06:00:44-05:00November 15, 2022|Medicaid|

Federal Health Policy Update for November 10

The following is the latest health policy news from the federal government for the week of November 7 to 10. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published a notice advising teaching hospitals that they have until November 18 to ask Medicare to reconsider their per resident amounts or resident caps as shown in the Hospital Cost Report Information System (HCRIS) associated with cost reports that, as of July 1, 2022, were not reopenable. Learn more from this CMS notice. Due to an unplanned system outage of [...]

iqtsupport2022-11-10T16:23:21-05:00November 10, 2022|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, MedPAC|

FEDERAL HEALTH POLICY UPDATE FOR November 3

The following is the latest health policy news from the federal government for the week of October 31 to November 3. Some of the language used below is taken directly from government documents. Medicare Payment Regulations In the past week CMS has published four regulations presenting how it will pay providers in the coming year. Outpatient prospective payment system – CMS announced a 3.8 percent increase for Medicare outpatient and ambulatory surgical payments. It also adopted its proposal to establish rural emergency hospitals as a new kind of hospital provider; removed 11 surgical procedures from its inpatient-only list and authorized [...]

iqtsupport2022-11-03T17:41:10-04:00November 3, 2022|340b, Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for October 27

The following is the latest health policy news from the federal government for the week of October 21 to October 27. Some of the language used below is taken directly from government documents. 340B Responding to a federal court ruling that the federal government has shortchanged hospitals in its payments for 340B-covered prescription drugs, CMS has announced how it will compensate hospitals for its underpayments – at least for the 2023 fiscal year. According to CMS, it “…will apply the default rate (generally ASP plus 6%) to 340B-acquired drugs for the rest of the year. CMS also will reprocess claims [...]

iqtsupport2022-10-27T17:06:24-04:00October 27, 2022|340b, Center for Medicare and Medicaid Innovation, CMMI, COVID-19, Medicaid, Medicaid regulations for long-term care, Medicare, Medicare reimbursement policy, MedPAC, post-acute care|

Results of Annual Survey of State Medicaid Programs

The Kaiser Family Foundation has published the results of its annual survey of state Medicaid programs for the 2022 and 2023 fiscal years. Among the survey’s findings (in language taken directly from the Kaiser report): More than 3/4 of states that contract with MCOs [managed care organizations] enroll ≥75% of all beneficiaries in MCOs Some states reported newly implementing or expanding MCO programs States also report continued use of other service delivery and payment system reforms Two-thirds of states are using strategies to improve race, ethnicity, and language data About one-quarter of states are tying MCO financial incentives to health [...]

iqtsupport2022-10-27T06:00:07-04:00October 27, 2022|COVID-19, Medicaid, Medicaid long-term services and supports, Medicaid managed care, social determinants of health, Telehealth|