Medicaid

Federal Health Policy Update for January 11

The following is the latest health policy news from the federal government for January 5 - 11. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS will establish 200 new Medicare-funded residency slots in FY 2025. Learn more about the additional slots here and find information about how to apply for those slots here. The deadline for applications is March 31. CMS released guidance for Medicare Part D plans that describes coverage and processing claims for COVID-19 therapeutics. Medicare Part D plans must cover commercially available oral antivirals for COVID-19 [...]

joe2024-01-11T21:27:47-05:00January 11, 2024|hospitals, MACPAC, Medicaid, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for January 4

The following is the latest health policy news from the federal government for December 21 to January 4. Some of the language used below is taken directly from government documents. No Surprises Act HHS, the departments of Labor and the Treasury, and the Office of Personnel Management intend to reopen the comment period for submitting comments on a proposed rule governing federal Independent Dispute Resolution (IDR) operations. They plan to publish a notice to this effect in the near future with further details on reopening the comment period. Department of Health and Human Services HHS’s Office of the National Coordinator [...]

joe2024-01-04T22:10:23-05:00January 4, 2024|Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, Federal Update, health equity, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for December 20

The following is the latest health policy news from the federal government December 14-20. Some of the language used below is taken directly from government documents. Congress The House is in recess until January 9. The Senate has delayed its recess to continue negotiations on a possible foreign aid and border policy deal. Democrats from the House Ways and Means Committee have published a report on the relationship between the U.S. health care system and climate change. View their report “Health Care and the Climate Crisis: Preparing America’s Health Care Infrastructure.” No Surprises Act The federal government has reopened the [...]

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 meeting. MACPAC’s December 2023 meeting opened with a session that highlighted findings related to sexual orientation and gender identity (SOGI) data collection as part of the Commission’s focus on the collection of primary language and limited English proficiency, SOGI, and disability data for the purposes of assessing and addressing health disparities. During this discussion, we reviewed the purpose of SOGI data and federal and state priorities for collecting these data, which includes an overview of [...]

joe2023-12-19T15:36:42-05:00December 19, 2023|Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations|

Federal Health Policy Update for December 14

The following is the latest health policy news from the federal government for December 8-14. Some of the language used below is taken directly from government documents. MedPAC Rate Recommendations At their latest public meeting, members of the Medicare Payment Advisory Commission voted preliminary approval of the following rate updates for 2025 Medicare payments: Inpatient and outpatient services –update provided for in current law plus 1.5% and adoption of a safety-net index policy to pay safety-net hospitals another $4 billion. Physicians and other health professionals –update of 50% of the Medicare economic index and a new add-on payment for services [...]

joe2023-12-14T22:30:50-05:00December 14, 2023|340b, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|

Federal Health Policy Update for December 7

The following is the latest health policy news from the federal government for December 1-7. Some of the language used below is taken directly from government documents. Congress While Congress has more than a month before the next federal funding deadline of January 19, committees are working to prepare and pass health care legislation. On the House calendar for floor votes next week is H.R. 5378, the Lower Costs, More Transparency Act. This bill would eliminate the pending cuts to Medicaid DSH for two years (those cuts are temporarily suspended through January 19); introduce site-neutral payments for drug administration services [...]

joe2023-12-07T21:50:17-05:00December 7, 2023|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

Feds Tackles State Medicaid Redetermination Problems With Penalties

The Centers for Medicare & Medicaid Services has unveiled plans to penalize states that fail to comply with federal standards for redetermining the eligibility of individuals who enrolled in their Medicaid programs during the COVID-19 emergency. Under a new CMS regulation, states that fail to report on their Medicaid eligibility efforts and comply with current requirements face penalties that include civil penalties and reductions in the rate at which the federal government matches state Medicaid expenditures. According to a new interim final rule, CMS is implementing … reporting requirements and enforcement authorities in the Social Security Act (the Act) that [...]

joe2023-12-05T16:30:03-05:00December 6, 2023|COVID-19, Medicaid|

Medicaid Redeterminations Trigger Increase in Self-Pay Care

As states continue redetermining Medicaid eligibility for participants who were protected from disenrollment during the COVID-19 emergency, the number of patients telling providers they will pay for their own hospital, primary care, and emergency department visits has risen. The increase in self-pay has been greatest for emergency department visits, and overall, the increases occurred most often in states that began disenrolling Medicaid participants as soon as the continuous eligibility afforded by the Families First Coronavirus Response Act ended. The rise in self-pay patients suggests that many previous Medicaid participants have not obtained new health insurance since their Medicaid eligibility ended. [...]

joe2023-11-30T19:16:48-05:00December 4, 2023|COVID-19, Medicaid|

Federal Health Policy Update for November 30

The following is the latest health policy news from the federal government for November 17-30. Some of the language used below is taken directly from government documents. No Surprises Act CMS has released two new FAQs to provide guidance in advance of the Independent Dispute Resolution portal reopening for batched disputes and air ambulance disputes; that service remains temporarily suspended. These FAQs together explain how certified IDR entities may determine whether a dispute is appropriately batched in light of recent court rulings; provide information about policy for extending existing IDR deadlines once the federal IDR portal reopens to all batched [...]

joe2023-11-30T20:59:02-05:00November 30, 2023|Centers for Medicare & Medicaid Services, COVID-19, Federal Update, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for November 16

The following is the latest health policy news from the federal government for November 10-16. Some of the language used below is taken directly from government documents. Congress This week Congress passed another continuing resolution (CR) to fund the federal government beyond Friday, when the current CR expires. This bill establishes two separate deadlines for lawmakers to pass certain spending bills so they can avoid an omnibus bill that includes all 12 appropriations bills. Congress must pass four of the spending bills by January 19 and the other bills by February 2. The Labor, HHS, and Education bill, one of [...]