Medicaid

Federal Health Policy Update for October 24

The following is the latest health policy news from the federal government for October 18-24. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has issued new guidance outlining regulatory requirements for hospitals to report specific data on COVID-19, flu, and RSV. The new weekly electronic reporting requirements will apply to short-term acute-care hospitals, long-term-care hospitals, critical access hospitals, Indian Health Service hospitals, children’s hospitals, and cancer hospitals, with other types of hospitals – psychiatric hospitals and distinct part units and inpatient rehabilitation hospitals and distinct part units – subject [...]

joe2024-10-24T14:58:32-04:00October 24, 2024|Affordable Care Act, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, post-acute care, Telehealth|

Federal Health Policy Update for September 26

The following is the latest health policy news from the federal government for September 20-26. Some of the language used below is taken directly from government documents. Congress Yesterday, Congress passed a continuing resolution to fund the federal government when the new federal fiscal year begins on October 1. The continuing resolution will extend funding for federal agencies at current levels through December 20 of this year. The bill did not include other significant policy provisions. President Biden will sign the bill this week and avoid a shutdown of the federal government. Find the bill text here. Following passage of [...]

joe2024-09-26T16:49:25-04:00September 26, 2024|Accountable Care Organization, ACO, Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Medicaid Enrollment Exceeds Pre-Pandemic Levels

While 25 million Americans have lost their Medicaid eligibility as a result of the post-pandemic “Medicaid unwinding” process, enrollment in the program today exceeds its pre-COVID level. Currently, Medicaid enrollment nationwide is 10 million more than it was in February of 2020, right before COVID struck. In all, 56 million people have had their Medicaid eligibility renewed while 25 million people were removed from the program’s rolls. The current situation varies from state to state; some states have seen enrollment rise while others have experienced enrollment declines. In some states, the status of enrollment gains and losses differs between adults [...]

joe2024-09-25T12:51:45-04:00September 26, 2024|Medicaid|

Feds Set End Date for “Medicaid Unwinding”

States need to complete their “Medicaid unwinding” activities by the end of 2026, the Centers for Medicare & Medicaid Services informed state Medicaid programs in a recent memo. According to the agency, … all states are required to complete a compliance assessment, demonstrate compliance with federal Medicaid and CHIP renewal requirements described at 42 C.F.R. §§ 435.916 and 457.343, and submit a plan outlining steps and milestones for addressing identified areas of non-compliance to CMS by December 31, 2024. Compliance plans will detail how states will achieve compliance with all applicable requirements no later than December 31, 2026. “Medicaid unwinding” [...]

joe2024-09-24T16:50:11-04:00September 25, 2024|Medicaid|

Federal Health Policy Update for September 19

The following is the latest health policy news from the federal government for September 13-29. Some of the language used below is taken directly from government documents. Congress Energy and Commerce Committee. Yesterday the House Energy and Commerce Committee marked up 16 bills, including several that address health care. These bills are unlikely to proceed to votes in the full House until after Congress returns following the November elections. The committee passed a bill that would extend the current telehealth waivers, scheduled to expire on December 31, for two years and would extend the Medicare Hospital at Home program, also [...]

joe2024-09-19T14:56:55-04:00September 19, 2024|340b, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for September 12

The following is the latest health policy news from the federal government for September 6-12. Some of the language used below is taken directly from government documents. 340B A federal court has declined to issue a preliminary order to block implementation of a Maryland law that requires pharmaceutical companies to provide discounts on drugs dispensed by eligible 340B providers by contract pharmacies. The challenge to the Maryland law, filed by Pharmaceutical Research and Manufacturers of America (PhRMA) and several pharmaceutical companies, will be heard without a temporary order suspending the law’s implementation. Learn more from the court order. Centers for [...]

joe2024-09-12T15:22:15-04:00September 12, 2024|340b, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for August 30

The following is the latest health policy news from the federal government for August 23-30. Some of the language used below is taken directly from government documents. 340B Johnson & Johnson, the pharmaceutical, biotechnology, and medical technologies company, told health care providers this week that it would shift from the long-time 340B upfront discount approach to a rebate model for two of its drugs and that eligible 340B hospitals and other providers will need to purchase the prescription drugs Stelara and Xarelto at list price and then, after dispensing them to patients, will need to submit 340B rebate claims to [...]

joe2024-08-30T15:03:18-04:00August 30, 2024|340b, Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid long-term services and supports, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|

Federal Health Policy Update for August 22

The following is the latest health policy news from the federal government for August 16-22. Some of the language used below is taken directly from government documents. The Courts The federal government must include uninsured patients whom hospitals serve under state Medicaid waivers when calculating hospitals’ Medicare DSH payments, a federal court has ruled. In the case of Baylor All Saints Medical Center, et al. v. Xavier Becerra, federal policymakers had invoked a 2023 regulation that excluded counting care provided to patients served by DSH-eligible hospitals providing care through state Medicaid waivers – generally, through uncompensated care pools. A group [...]

joe2024-08-22T15:11:48-04:00August 22, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for August 15

The following is the latest health policy news from the federal government for August 9-15. Some of the language used below is taken directly from government documents. Department of Health and Human Services To advance its implementation of the 2009 Health Information Technology for Economic and Clinical Health Act (HITECH Act), HHS has published a proposed regulation that would amend and update its Health and Human Services Acquisition Regulation. The proposed regulation would require health care organizations that contract with HHS to comply with standards for data exchange adopted by the Office of the National Coordinator for Health Information Technology [...]

joe2024-08-15T16:35:34-04:00August 15, 2024|Accountable Care Organization, ACO, Alternative payment models, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, post-acute care|

Federal Health Policy Update for August 8

The following is the latest health policy news from the federal government for August 3-8. Some of the language used below is taken directly from government documents. No Surprises Act A federal appeals court has upheld a February lower court ruling that found that the current No Surprises Act’s arbitration process for addressing payment disagreements between payers and providers favored payers by giving too much weight to “qualifying payment amounts,” which are the median of what insurers contract to pay providers in a given geographic area. Learn more from the appeals court’s decision in the case. Department of Health and [...]

joe2024-08-08T15:01:05-04:00August 8, 2024|340b, Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, social determinants of health, Telehealth|