Medicaid

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|

Federal Health Policy Update for February 16

The following is the latest health policy news from the federal government for February 6-16. Some of the language used below is taken directly from government documents. No Surprises Act A federal judge in Texas has vacated parts of a regulation governing the arbitration process that is a major aspect of implementation of the No Surprises Act. In his ruling, the judge found that the arbitration process unfairly favored payers over providers, most notably by placing undue emphasis on the qualified payment amount (QPA) that is a major part of the arbitration process. The decision explains that “The Court first [...]

iqtsupport2023-02-16T17:02:31-05:00February 16, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations|

Federal Health Policy Update for February 6

The following is the latest health policy news from the federal government for the week of January 23 to February 6. Some of the language used below is taken directly from government documents. 340B Pharmaceutical companies may restrict the ability of providers to use specialty and community pharmacies to distribute 340B-covered drugs, a federal appeals court has decided. See the court’s ruling here. Centers for Medicare & Medicaid Services CMS has revised its fact sheets about COVID-19 public health emergency waivers and flexibilities for different types of providers, updating which waivers and flexibilities have already been terminated, which have been [...]

iqtsupport2023-02-06T17:03:31-05:00February 6, 2023|340b, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for January 20

The following is the latest health policy news from the federal government for the week of January 13-20. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published updates to the Healthcare Common Procedure Coding System (HCPCS) codes on the Required Face-to-Face Encounter and Written Order Prior to Delivery List. The update adds ten codes to the list of items that require a face-to-face encounter between provider and patient and a written order prior to delivery as a condition of payment. Go here for a summary of the update [...]

iqtsupport2023-01-20T15:28:07-05:00January 20, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for January 12

The following is the latest health policy news from the federal government for January 6-12. Some of the language used below is taken directly from government documents. Renewal of COVID-19 Public Health Emergency Declaration HHS Secretary Xavier Becerra has signed an order extending the previous declaration of a COVID-19 public health emergency. This declaration extends the emergency to April 11. The administration continues to assure stakeholders it will provide 60 days’ notice prior to the end of the public health emergency. MedPAC Medicare Rate Recommendations Every year MedPAC recommends to Congress rate increases for the different kinds of health care [...]

iqtsupport2023-01-12T19:22:04-05:00January 12, 2023|Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for January 5

The following is the latest health policy news from the federal government for December 23 through January 5. Some of the language used below is taken directly from government documents. No Surprises Act HHS, the Department of Labor, and the Department of the Treasury have announced increases in the administrative fee for initiating the No Surprises Act’s Independent Dispute Resolution (IDR) process and for certified IDR entities. Learn more about the administrative fee change here and about the certified IDR entity fee change here. Both changes took effect on January 1. HHS, the Department of Labor, and the Department of the [...]

iqtsupport2023-01-05T17:15:07-05:00January 5, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for December 22

The following is the latest health policy news from the federal government for the week of December 19-22. Some of the language used below is taken directly from government documents. Congress As of this writing, Congress continues to work on an FY 2023 omnibus spending bill: the Senate has passed it but the House has not yet addressed it. Highlights of what negotiators have agreed to – but that have not yet been adopted – include: Preventing the additional four percent Medicare sequester for two years. Reducing by more than half the 4.5 percent cut in Medicare payments to physicians [...]

iqtsupport2022-12-22T17:30:38-05:00December 22, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, hospitals, Medicaid, Medicare, Medicare bad debt reimbursement, Medicare regulations, Medicare reimbursement policy, Telehealth|

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|