Medicaid

Federal Health Policy Update for October 5

The following is the latest health policy news from the federal government for September 29 to October 5. Some of the language used below is taken directly from government documents. Congress Last Saturday, Congress passed a 45-day continuing resolution (CR) to fund the federal government through November 17. Part of that limited CR includes a delay of the scheduled $8 billion cut to Medicaid DSH allotments to states through the end of the CR. The bill also extends funding for community health centers and the National Health Services Corps for the same length of time. Congress will have to act [...]

iqtsupport2023-10-05T14:53:32-04:00October 5, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for September 28

The following is the latest health policy news from the federal government for September 22-28. Some of the language used below is taken directly from government documents. The White House President Biden has signed H.R. 2544, the Securing the U.S. Organ Procurement and Transplantation Network Act, which provides for awarding multiple grants, contracts, or cooperative agreements to operate the Organ Procurement and Transplantation Network. Congress Congressional leaders have not come to agreement on how to avert a federal government shutdown this weekend. While Senate leaders introduced a continuing resolution that would fund the government through November 17, that bill has [...]

iqtsupport2023-09-28T16:38:25-04:00September 28, 2023|Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Telehealth|

Federal Health Policy Update for September 21

The following is the latest health policy news from the federal government for September 15 - 21. Some of the language used below is taken directly from government documents. Congress With only nine days left in the current federal fiscal year, Congress still has not agreed on any kind of spending bill to keep the federal government operating past September 30. If the federal government shuts down, the Department of Health and Human Services (HHS) will “use the full extent of the authority under the Antideficiency Act (ADA) to maintain existing HHS activities…” In previous shutdowns, Medicare has continued to [...]

iqtsupport2023-09-21T15:37:11-04:00September 21, 2023|Alternative payment models, Congress, COVID-19, Medicaid, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for September 7

The following is the latest health policy news from the federal government for September 1-7. Some of the language used below is taken directly from government documents. Congress House Republicans plan to introduce the Lower Cost, More Transparency Act for consideration before the end of the year. This bill includes provisions passed by three committees with health care jurisdiction: House Ways & Means, Energy & Commerce, and Education & Workforce. Some of the bill’s provisions would: eliminate scheduled Medicaid DSH cuts for FY 2024 and FY 2025; reauthorize and extend funding for the Community Health Center program, the National Health [...]

iqtsupport2023-09-07T16:39:42-04:00September 7, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|

Federal Health Policy Update for August 31

The following is the latest health policy news from the federal government for August 25-31. Some of the language used below is taken directly from government documents. No Surprises Act For the second time in less than a month a court has rejected how federal agencies are implementing the Independent Dispute Resolution process of the No Surprises Act. A federal court concluded that the process for establishing the Qualifying Payment Amount, or QPA – the median rate insurers pay for in-network services and a critical factor in settling payment disputes – inappropriately permits insurers to depress that rate and unfairly [...]

iqtsupport2023-08-31T16:09:59-04:00August 31, 2023|Centers for Medicare & Medicaid Services, Medicaid, Medicare, MedPAC|

Supply of Nursing Home Beds Declining

The number of nursing home beds in the U.S. is fast declining, according to a new analysis commissioned by the American Health Care Association, a nursing home trade group. According to the study, 21 percent of nursing home operators have downsized – dropped beds or units. 55 percent have turned away people seeking nursing home beds. 48 percent have waiting lists. 579 facilities have closed since 2020, and along with them, the supply of nursing home beds fell by more than 45,000. Nursing home operators cite a number of reasons for the decline, including current reimbursement practices – especially for [...]

iqtsupport2023-08-28T06:00:39-04:00August 28, 2023|hospitals, Medicaid, post-acute care|

Federal Health Policy Update for August 24

The following is the latest health policy news from the federal government for August 11-24. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services After suspending the No Surprises Act-created Independent Dispute Resolution process in the wake of a court ruling striking down a recent increase in fees for that process, CMS has established a new rate structure for initiating the adjudication of payment disagreements between providers and payers. It explains the new rate structure in this new FAQ, which nevertheless notes that despite the creation of new rates, the Independent [...]

States Introduce Changes on Medicaid Unwinding

With more than five million people already dropped from state Medicaid rolls and the federal government telling them they are not doing a good job, some states are introducing changes in how they review the eligibility of their Medicaid population as part of the Medicaid unwinding process. With the end of the formal public health emergency and continuous Medicaid eligibility, states have begun the significant challenge of reviewing the eligibility of all of their Medicaid participants. Last month the Centers for Medicare & Medicaid Services sent letters to all 50 states outlining their individual shortcomings in their efforts so far. [...]

iqtsupport2023-08-23T06:00:10-04:00August 23, 2023|Medicaid|

Feds Pointing Fingers on Medicaid Unwinding Shortcomings

After months of vague, general assertions about shortcomings in states’ efforts to redetermine the eligibility of their Medicaid participants as part of the post-pandemic continuous Medicaid unwinding process, the federal government is now revealing which states are having problems – and what those problems are. In public letters to the 50 states, the Centers for Medicare & Medicaid Services cites three major shortcomings in states’ efforts: paperwork problems, long call center waiting times, and the slow processing of applications. According to the letters, 36 states are falling short on at least one of these measures and five are failing on [...]

iqtsupport2023-08-16T06:00:38-04:00August 16, 2023|Medicaid|

Federal Health Policy Update for August 10

The following is the latest health policy news from the federal government for August 4-10. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has temporarily suspended the federal Independent Dispute Resolution process, which adjudicates problems involving surprise medical bills, in the wake of a federal court ruling that found some of the process’s underlying regulations invalid. CMS has directed the certified Independent Dispute Resolution entities to pause all dispute resolution activities. As a result, providers and insurers temporarily cannot initiate new disputes. Learn more from this CMS notice. CMS [...]

iqtsupport2023-08-10T16:32:27-04:00August 10, 2023|Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|