Medicaid

The Potential Impact of the Senate’s Proposed Medicaid Cuts

After the House passed its FY 2025 budget reconciliation bill the Senate took up its own bill, with the Senate Finance Committee proposing more than $800 billion in Medicaid cuts through a combination of reduced future Medicaid provider taxes, new limits on state directed payments made through Medicaid managed care plans, new Medicaid work requirements, more frequent redetermination of Medicaid eligibility, a shorter period of retroactive eligibility for Medicaid and the Children’s Health Insurance Program, and more. The Senate continues to debate these proposals, with some members believing they are necessary and appropriate and others arguing that they would have [...]

joe2025-06-25T12:53:57-04:00June 26, 2025|Congress, Medicaid|

Federal Health Policy Update for June 19

The following is the latest health policy news from the federal government for June 13-19. Some of the language used below is taken directly from government documents. Congress The Senate Finance Committee The Senate Finance Committee has released its portion of the FY 2025 budget reconciliation bill. Major proposals include: A freeze on the size of Medicaid provider taxes, phased down reductions of current taxes toward a new, lower limit for many states, and new terms under which provider taxes can be approved. New limits on the use of Medicaid state directed payments so they eventually will not exceed 100 [...]

joe2025-06-19T16:17:10-04:00June 19, 2025|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare reimbursement policy|

Federal Health Policy Update for June 12

The following is the latest health policy news from the federal government for June 6-12. Some of the language used below is taken directly from government documents. Congress Republican senators continue to work on their version of a reconciliation bill with a goal of passage by July 4, although that deadline may slip. Some Senate committees have begun releasing their portions of the bill but the Finance Committee’s bill, with its tax and Medicaid provisions, has not yet been released. Among the majority party in the Senate, fault lines around the House-passed reconciliation bill remain around Medicaid provider taxes, state [...]

joe2025-06-12T16:32:26-04:00June 12, 2025|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Administration Targets State Directed Medicaid Payments

The White House has issued a presidential memorandum on “Eliminating Waste, Fraud, and Abuse in Medicaid” that cites Medicaid “state-directed payments” as a form of waste, fraud, and abuse. According to the memorandum, states use state directed payments to pay more than Medicare rates for some Medicaid-covered services – something the memorandum suggests is contrary to current practice because “…billable costs for such care were historically capped at the same level that healthcare providers could receive from Medicare.” This assertion comes despite a 2024 regulation that set the payment limit for state directed payments at the average commercial rate and [...]

joe2025-06-11T10:22:01-04:00June 11, 2025|Medicaid, Medicaid managed care, Medicaid regulations|

Federal Health Policy Update for June 5

The following is the latest health policy news from the federal government for May 30 to June 5. Some of the language used below is taken directly from government documents. Congress Congress returned to Washington D.C., where Republican senators continue to work on their version of a reconciliation bill with a goal of passage by the full Congress by July 4. Some Senate committees have begun releasing their portions of the bill but the committees with jurisdiction over Medicaid – the Finance and Health, Education, Labor, and Pensions (HELP) committees – have not committed to a timeline for their bills. [...]

joe2025-06-05T16:50:48-04:00June 5, 2025|Congress, hospitals, Medicaid, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for May 29

The following is the latest health policy news from the federal government for May 23-29. Some of the language used below is taken directly from government documents. Congress The House and Senate are out of Washington, D.C. this week for the Memorial Day holiday and will return to Washington on June 3. Senate Republican staff is working on the House-passed reconciliation bill to identify provisions that may need to change or be excluded to comply with the Senate’s rules for reconciliation bills. At the same time, some Republican senators have expressed opposition to the House reconciliation bill; some maintain that [...]

joe2025-05-29T15:36:56-04:00May 29, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for May 22

The following is the latest health policy news from the federal government for May 16-22. Some of the language used below is taken directly from government documents. Congress: Reconciliation Early Thursday morning the House of Representatives passed its version of an FY 2025 budget reconciliation bill by a vote of 215-214. The bill underwent a number of changes during the hours before its passage and its health care provisions now include $800 billion in Medicaid cuts over the next ten years. The Congressional Budget Office projects that the bill, mostly because of the Medicaid cuts, will lead to 8.6 million [...]

joe2025-05-23T10:22:33-04:00May 23, 2025|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, COVID-19, deficit reduction, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for May 15

The following is the latest health policy news from the federal government for May 9-15. Some of the language used below is taken directly from government documents. Congress: Reconciliation House Energy and Commerce Committee Charged with finding $880 billion in federal spending cuts over the next ten years, the House Energy and Commerce Committee this week produced legislative language to be included in a House reconciliation bill that would achieve that objective. The committee’s cost-cutting provisions include: Freezing state Medicaid provider taxes at their current level, prohibiting the establishment of new provider taxes, modifying the criteria CMS uses to determine [...]

joe2025-05-15T17:19:56-04:00May 15, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, deficit reduction, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations, Medicare, Medicare cuts, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for May 8

The following is the latest health policy news from the federal government for May 2-8. Some of the language used below is taken directly from government documents. Congress Reconciliation Over the past several days the political gravity surrounding Medicaid cuts has begun to shift slightly. Moderate Republicans have been pushing back more forcefully and more loudly against such cuts, with some saying they will not support more than work requirements and increased enforcement checks for eligibility. Opposition to most Medicaid cuts led the Energy and Commerce Committee to delay a markup of its reconciliation bill planned for this week to [...]

joe2025-05-08T16:50:48-04:00May 8, 2025|Accountable Care Organization, Alternative payment models, Congress, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for May 1

The following is the latest health policy news from the federal government for April 25 – May 1. Some of the language used below is taken directly from government documents. Congress Reconciliation The House and Senate returned to Washington D.C. this week and House committees have begun marking up reconciliation legislation for submission to the House Budget Committee by May 9. The Energy and Commerce Committee is expected to seek nearly $550 billion in cuts to Medicaid spending and the most likely targets for cuts continue to be work requirements for Medicaid eligibility; more frequent review of Medicaid eligibility; reducing the federal [...]

joe2025-05-01T15:33:24-04:00May 1, 2025|Centers for Medicare & Medicaid Services, Congress, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|