Medicare

Federal Health Policy Update for November 6

The following is the latest health policy news from the federal government for October 31 – November 6. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown; some are engaging in limited exceptions. Congress and the Shutdown Senate Majority Leader John Thune (R-SD) today told his caucus that he plans to bring the House-passed CR to yet another vote in the Senate on [...]

joe2025-11-06T21:35:12-05:00November 6, 2025|340b, Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for October 30

The following is the latest health policy news from the federal government for October 24-30. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown. Congress and the Shutdown The federal government remains shut down and the Senate expects to leave Washington today without another vote on the House-passed continuing resolution (CR), ensuring that the shutdown will continue into next week. Republican leaders believe [...]

joe2025-10-31T12:15:23-04:00October 30, 2025|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, Medicaid, Medicare|

CMS Employees Return to Work

The Centers for Medicare & Medicaid Services has recalled 3000 employees – 47 percent of its workforce – furloughed earlier this month when the federal government shutdown began. In a published report, a CMS spokesperson explained that “In order to best serve the American people amid the Medicare and Marketplace open enrollment seasons, CMS is temporarily calling back all furloughed employees on Monday, October 27.” In addition to working on Medicare and Marketplace open enrollment, some of the employees returning to work also will participate in the review of applications for Rural Health Transformation Program funding. The deadline for states [...]

joe2025-10-29T11:35:05-04:00October 30, 2025|Centers for Medicare & Medicaid Services, Medicare|

Federal Health Policy Update for October 23

The following is the latest health policy news from the federal government for October 17 - 23. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown. Congress and the Shutdown The Senate postponed its 13th vote on the House-passed continuing resolution (CR), scheduled for today; without bipartisan negotiations on Affordable Care Act enhanced premium subsidies, the measure – whenever the next vote is [...]

joe2025-10-23T15:32:04-04:00October 23, 2025|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicare|

Hospital at Home Program in Limbo

Medicare’s Acute Hospital Care at Home program is in limbo after the law authorizing it lapsed at the end of the 2025 federal fiscal year on September 30. As a result of this loss of authorization, CMS directed the more than 300 hospitals that participate in the program and care for seriously ill patients in their homes to discharge current participants or bring them back into their hospital. The program, created during the COVID-19 pandemic to free hospital beds for sicker patients who also were highly contagious, has been credited with lower mortality rates, reduced crowding in hospital emergency rooms, [...]

joe2025-10-15T12:52:33-04:00October 17, 2025|Medicare|

Misinterpretation of Shutdown Plagues Telehealth

When federal authorization for Medicare-covered telehealth services lapsed at the end of the federal fiscal year on September 30, it was only supposed to affect traditional Medicare participants. But not everyone got the message. Some providers, confused about the lapse of Medicare authorization, are refusing to prescribe telehealth services for their non-Medicare patients. In addition, some health insurers are declining to cover telehealth services for their non-Medicare patients, misinterpreting the scope of the loss of Medicare authorization for telehealth care – something they should not be doing, according to a health insurance industry trade group. Older patients, patients with limited [...]

joe2025-10-14T11:45:35-04:00October 14, 2025|Medicare, Telehealth|

Federal Health Policy Update for October 9

The following is the latest health policy news from the federal government for October 3-9. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown. Congress and the Shutdown Today the Senate voted on separate Democratic- and Republican-led continuing resolutions (CRs) for the seventh time but again was unable to reach the 60-vote majority needed to pass a measure. Once again, only three Democratic senators [...]

joe2025-10-09T15:13:15-04:00October 9, 2025|Centers for Medicare & Medicaid Services, Congress, Medicaid, Medicaid managed care, Medicare|

Federal Health Policy Update for October 3

The following is the latest health policy news from the federal government for September 26 to October 3. Some of the language used below is taken directly from government documents. Health Care During the Government Shutdown With the federal government technically without spending authority now that FY 2026 has begun without an approved FY 2026 budget, the federal role in health care will change in some respects and be greatly reduced in others. Medicare and Medicaid will continue to function; previous legislation ensures Medicaid funding through the first quarter of FY 2026. States will continue to receive federal funding to [...]

joe2025-10-03T14:33:33-04:00October 3, 2025|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicare, Medicare reimbursement policy, Telehealth|

Hospitals to Face More Readmissions Penalties in 2026

Hospital readmissions penalties will increase, as will the size of the typical penalty, in the coming year. Beginning in FY 2026, the proportion of hospitals that will be penalized at least one percent for excessive readmissions under the Centers for Medicare & Medicaid Services’ Hospital Readmissions Reduction Program will rise from seven percent of all hospitals to eight percent. The number of hospitals penalized less than one percent will decline. Hospitals that care for the highest proportions of dually eligible Medicare/Medicaid patients will see their penalties increase slightly. The penalties levied in FY 2026 will reflect hospital performance between July [...]

joe2025-09-26T10:48:58-04:00September 30, 2025|Centers for Medicare & Medicaid Services, Medicare|

Federal Health Policy Update for September 25

The following is the latest health policy news from the federal government for September 19-25. Some of the language used below is taken directly from government documents. Federal Funding for Fiscal Year 2026 Telehealth and Acute Hospital Care at Home Program Flexibilities Many current telehealth flexibilities and authorization for the Acute Hospital Care at Home program will expire on September 30 unless Congress extends them. The following is CMS’s current guidance on these programs if they are not extended by September 30: The CMS Acute Hospital Care at Home web page advises stakeholders that The Acute Hospital Care at Home [...]