Medicare

Medicare, Medicaid Regulations Logjam Should Soon End

The shutdown of the federal government brought the usual flow of Medicare and Medicaid regulations to an almost complete halt. Now that the shutdown has ended, the logjam should end fairly quickly – and with a sense of urgency. Currently, a number of major Medicare and Medicaid regulations remain with the Office of Management and Budget for review. Even though the shutdown has now ended, it is not yet clear when they will be addressed. By statute, the following regulations must be implemented by January 1. CY 2026 Hospital Outpatient Prospective Payment System Policy Changes and Payment Rates and Ambulatory [...]

joe2025-11-13T17:00:30-05:00November 18, 2025|Alternative payment models, Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Health Care and the End of the Shutdown

Passage last week of a continuing resolution to fund the federal government brought the 43-day shutdown to an end – and relief for many health care organizations and the people and communities they serve. The final continuing resolution, which extended federal funding through the end of January of next year, includes: Restoring the delay of reductions of Medicaid disproportionate share hospital (Medicaid DSH) payments. Extending authorization for the Medicare Acute Hospital Care at Home program and Medicare telehealth flexibilities. Extending the low-volume hospital adjustment program and the Medicare-dependent hospital program all through that same date. The bill waives the pay-as-you-go [...]

joe2025-11-13T16:30:32-05:00November 17, 2025|Affordable Care Act, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for November 13

The following is the latest health policy news from the federal government for November 7-13. Some of the language used below is taken directly from government documents. Please note that during the federal government shutdown, most HHS and other health care-related agencies, with limited exceptions, engaged in little public activity such as announcements, the publication of new regulations, and updating their web sites. Now that the shutdown has ended, normal activity can be expected to resume shortly. The End of the Federal Government Shutdown On Wednesday night the House passed the Senate-amended version of the continuing resolution (CR) in a [...]

joe2025-11-13T15:20:05-05:00November 13, 2025|Affordable Care Act, Alternative payment models, 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|

Senate Bill Includes Provisions Vital to Many Hospitals

Last weekend the Senate passed a bill that could, if negotiated successfully with and adopted by the House, temporarily end the current federal government shutdown. Included in the Senate-passed bill are so-called health care extenders that are important to many hospitals, including: A delay in cuts in Medicaid disproportionate share hospital (Medicaid DSH) allotments to the states. A temporary extension of COVID-era telehealth flexibilities. Extension of the Medicare low-volume hospital and Medicare-dependent hospital programs. Extension of authorization for Medicare’s Acute Hospital at Home program. Extension of funding for Community Health Centers and teaching hospitals that operate graduate medical education (GME) [...]

joe2025-11-10T12:19:59-05:00November 10, 2025|Affordable Care Act, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

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|