Medicaid

Preventable Medicaid Hospitalizations Vary Based on Race, Eligibility Path

Preventable hospitalizations among Medicaid patients vary based on the race of the patient and how that patient came to be eligible for Medicaid, according to a new analysis by the Urban Institute. According to a review of preventable hospitalizations in 21 states, the report concluded that: … the three most common types of potentially preventable hospitalizations for Medicaid-enrolled adults were asthma/COPD (0.2 percent of enrollees had at least one such hospitalization in 2019), diabetes (0.4 percent of enrollees had at least one such hospitalization in 2019), and heart failure (0.2 percent of enrollees had at least one such hospitalization in [...]

joe2024-01-29T19:09:49-05:00January 30, 2024|health equity, Medicaid|

Federal Health Policy Update for January 25

The following is the latest health policy news from the federal government for January 12 - 25. Some of the language used below is taken directly from government documents. Department of Health and Human Services – Funding Models HHS has announced a new model to test approaches for addressing the behavioral and physical health and health-related social needs of people with Medicaid and Medicare. The goal of the Innovation in Behavioral Health Model (IBH) is to improve the overall quality of care and outcomes for adults with mental health conditions and/or substance use disorders by connecting them with the physical, behavioral, [...]

joe2024-01-25T22:30:26-05:00January 25, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health, Telehealth|

Analysis Looks at Problems Plaguing Unwinding of Medicaid Continuous Eligibility

Since the end of the continuous Medicaid eligibility that was a major part of the Families First Coronavirus Response Act, more than 14 million Americans have lost their Medicaid eligibility. In a new analysis, KFF looks at the challenges both consumers and states have encountered in attempting to review the eligibility of the Medicaid population and to ensure that those who are no longer eligible can be directed to other options for health insurance. Among the factors addressed in this analysis are: State outreach to affected individuals, the effectiveness of those efforts, and the adjustments states have made along the [...]

joe2024-01-23T20:01:41-05:00January 24, 2024|hospitals, Medicaid|

Congress Spares Medicaid DSH Cut – for Now

An oft-delayed cut in Medicaid disproportionate share allotments to states was delayed once again in the latest temporary spending bill passed by Congress last week. The stopgap spending bill, which runs until March 8, delays an $8 billion a year cut in Medicaid DSH payments that was part of the Affordable Care Act and has been put off by Congress on numerous occasions ever since. The reduction was envisioned as an appropriate move in anticipation of a significant increase in uninsured Americans after the 2010 reform law’s passage. While that increase has occurred, many hospitals continue to care for significant [...]

joe2024-01-23T19:58:33-05:00January 23, 2024|Affordable Care Act, Medicaid, Medicaid DSH, Medicaid DSH allotments|

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|