Medicaid

Paxlovid Will Soon Cost Patients

Free Paxlovid treatment for COVID-19 will soon be a thing of the past for many people because in the coming months the federal government plans to stop paying for the drug for everyone who needs it. Nearly six million Americans so far have taken Paxlovid after being diagnosed with COVID, but by the middle of 2023 the federal government is expected to stop footing the bill. Currently, it pays $530 a dose – a discounted price. When that happens the drug may become far less accessible. Because Paxlovid is only authorized under federal emergency use authorization, Medicare drug plans are [...]

iqtsupport2022-12-16T06:00:16-05:00December 16, 2022|COVID-19, Medicaid, Medicare|

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15. Some of the language used below is taken directly from government documents. White House The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans. Learn more about the plan from this White House fact sheet and go here for a transcript of the White House [...]

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 December 2022 MACPAC meeting began with a Commission discussion on two potential recommendations for improving Medicaid race and ethnicity data reporting. As part of its commitment to prioritizing health equity in all of its work, the Commission is focused on how to improve Medicaid race and ethnicity data collection and reporting. In October, staff presented findings from a literature review and key stakeholder interviews, as well as possible approaches for improving the collection [...]

iqtsupport2022-12-15T06:00:20-05:00December 15, 2022|hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care|

CBO Looks For Cost-Cutting Opportunities

The Congressional Budget Office periodically issues a compendium of policy options for changing federal tax and spending policies in particular areas and reducing federal spending. For each option the CBO presents an estimate of its effect on the budget without making recommendations either in favor of or against those options. The latest update of options includes a number with potential implications for health care providers, including: changing the cost-sharing rules for Medicare and restricting medigap insurance reducing Medicare Advantage benchmarks reducing Medicare’s coverage of bad debt consolidating and reducing federal payments for graduate medical education at teaching hospitals establishing caps [...]

iqtsupport2022-12-13T06:00:58-05:00December 13, 2022|deficit reduction, hospitals, Medicaid, Medicare, Medicare bad debt reimbursement|

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|