Medicaid

Federal Health Policy Update for May 23

The following is the latest health policy news from the federal government for May 18-23. Some of the language used below is taken directly from government documents. Congress Leaders of the Senate Finance Committee have released a white paper outlining potential reforms of how Medicare pays physicians and how Medicare might better meet the needs of those with chronic illnesses. The white paper notes areas of interest the committee sees as opportunities for reform, including: Creating sustainable payment updates to ensure clinicians can own and operate their practices. Creating incentives for alternative payment models that reward providing better care at [...]

joe2024-05-23T18:28:33-04:00May 23, 2024|340b, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for May 17

The following is the latest health policy news from the federal government for May 10-17. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced a further extension of deadlines for fulfilling certain Medicaid unwinding requirements. Some current deadlines will be extended to December 31, 2024 and others through June 30, 2025. States also may seek to extend selected COVID-19-related flexibilities through June 30, 2025. Among the deadlines affected by this announcement are those for using ex parte information to determine eligibility; permitting Medicaid managed care organizations to help [...]

joe2024-05-17T20:18:34-04:00May 17, 2024|Centers for Medicare & Medicaid Services, health equity, hospitals, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, social determinants of health|

Medicaid Unwinding Extended

The federal government is giving states more time to complete their Medicaid unwinding process – and people still on the Medicaid rolls more time to apply to retain their Medicaid eligibility. In a memo to state Medicaid programs, the Centers for Medicare & Medicaid Services wrote that To continue supporting states’ efforts to establish and update income and eligibility determination systems that maximize states’ ability to ensure that eligible individuals retain coverage, CMS is further extending these unwinding-related…waivers through June 30, 2025. When the Families First Coronavirus Response Act’s prohibition against removing people from state Medicaid rolls ended with the [...]

joe2024-05-15T17:07:11-04:00May 15, 2024|COVID-19, Medicaid|

Federal Health Policy Update for May 9

The following is the latest health policy news from the federal government for May 3-9. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services HHS and CMS have announced the Increasing Organ Transplant Access Model, which seeks to increase access to kidney transplants for people living with end-stage renal disease (ESRD), improve the quality of care for people seeking kidney transplants, reduce disparities among individuals undergoing the process of receiving a kidney transplant, and increase the efficiency and capability of transplant hospitals selected to participate. Hospitals eligible to be selected for [...]

joe2024-05-09T20:32:32-04:00May 9, 2024|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, health equity, hospitals, Medicaid, Medicare, social determinants of health|

Federal Health Policy Update for May 2

The following is the latest health policy news from the federal government for April 26 – May 2. Some of the language used below is taken directly from government documents. No Surprises Act – Independent Dispute Resolution Process CMS has announced a new process for resubmitting Independent Dispute Resolution (IDR) disputes that were originally improperly batched or bundled.This new resubmission process is automated in the federal IDR portal and seeks to streamline federal IDR operations. For further information about this new process and an implementation timetable, see this CMS announcement. CMS also has posted a user guide for the IDR [...]

joe2024-05-02T19:49:55-04:00May 2, 2024|Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for April 25

The following is the latest health policy news from the federal government for April 9-25. Some of the language used below is taken directly from government documents. Updated 340B Arbitration Process Last week HHS’s Health Resources and Services Administration (HRSA) published a regulation modifying the administrative dispute resolution (ADR) process it uses to adjudicate payment disputes between 340B-eligible providers and pharmaceutical companies. The major changes in the ADR process include the use of HRSA experts to serve on ADR panels; elimination of the $25,000 damage threshold for filing a claim; 340B-eligible providers may now challenge manufacturers that seek to prevent [...]

joe2024-04-25T20:25:44-04:00April 25, 2024|340b, Accountable Care Organization, ACO, Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid long-term services and supports, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care, Medicaid regulations for the disabled, Medicare, Medicare post-acute care, Medicare regulations, post-acute care|

Federal Health Policy Update for April 18

The following is the latest health policy news from the federal government for April 12-18. Some of the language used below is taken directly from government documents. The White House The administration has launched a new global health security strategy that seeks to drive action across federal departments and agencies and rally support from other countries, the private sector, and civil society to better prevent, detect, respond to, and recover from infectious disease threats. The strategy seeks to build on the lessons learned from the response to the COVID-19 pandemic. Learn more from this White House statement; the administration’s strategy [...]

joe2024-04-18T19:03:57-04:00April 18, 2024|340b, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, MedPAC|

A Look at Medicaid Home- and Community-Based Services

The National Association of Medicaid Directors has published a blog post offering background information about the role of state Medicaid programs in the delivery of home- and community-based services. The brief addresses such questions as: What are home- and community-based services? How do home- and community-based services vary across states and territories? What are the federal pathways for Medicaid coverage of home- and community-based services? How do states deliver home- and community-based services? How does this affect how a person receives HCBS services? What factors will affect the future of Medicaid HCBS? Learn more from the National Association of Medicaid [...]

joe2024-04-17T16:12:22-04:00April 18, 2024|Medicaid|

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met publicly last week in Washington, D.C. The following is MACPAC’s own summary of its meeting. The April 2024 Commission meeting began with a presentation of a draft chapter on demographic data collection in Medicaid for the June Report to Congress. Racial and ethnic health disparities persist throughout the U.S. health care system. Previous meetings have focused on the collection of primary language and limited English proficiency, sexual orientation and gender identity (SOGI), and disability data to help assess and address these health disparities. Measuring differences in access and use of [...]

joe2024-04-16T17:34:59-04:00April 17, 2024|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid long-term services and supports, Medicaid regulations|

Federal Health Policy Update for April 12

The following is the latest health policy news from the federal government for April 5-11. Some of the language used below is taken directly from government documents. CMS – Proposed FY 2025 Medicare Inpatient Prospective Payment System Regulation Earlier this week CMS issued its proposed FY 2025 Medicare inpatient prospective payment system regulation – the rule under which it envisions paying acute-care hospitals, critical access hospitals, and long-term care hospitals for inpatient care in the coming fiscal year. Highlights of the proposed rule include: Rate increases of 2.6 percent for acute-care and critical access hospitals and 2.8 percent for LTCHs. [...]