Medicare

Medicare Innovations Foster Focus on Behavioral Health

A number of recent changes in the Medicare program appear designed to make it easier for beneficiaries to pursue behavioral health assistance. Among them: A greater focus on the integration of physical and behavioral health. A greater willingness to pay for digital behavioral health interventions. The release of several requests for information addressing behavioral health services. The introduction of new behavioral health procedure and billing codes. The inclusion of behavioral health in new Medicare models, including the LEAD (Long-Term Enhanced ACO Design) Model, the ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model, and the MAHA ELEVATE (Make America Healthy [...]

joe2026-04-23T15:06:02-04:00April 27, 2026|ACO, Alternative payment models, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for April 23

The following is the latest health policy news from the federal government for April 17-23. Some of the language used below is taken directly from government documents. The White House President Trump has issued an executive order calling for accelerated access to medical treatments for patients with serious mental illness, with an emphasis on greater access to psychedelic drugs. Learn more from this executive order and an accompanying White House fact sheet. Shortly after the White House issued this executive order, HHS’s Advanced Research Projects Agency for Health (ARPA-H) announced the first set of research teams for its Evidence-Based Validation [...]

joe2026-04-23T16:43:24-04:00April 23, 2026|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for April 16

The following is the latest health policy news from the federal government for April 11-16. Some of the language used below is taken directly from government documents. CMS – New Proposed Regulations FY 2027 Medicare Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System Proposed Rule CMS has published its proposed FY 2027 Medicare hospital inpatient and long-term-care hospital prospective payment system rule. The highlights of the proposed rule are: A 2.4 percent rate increase for both acute-care hospital inpatient and long-term care hospital services. A $564 million reduction in Medicare disproportionate share hospital (Medicare DSH) and [...]

joe2026-04-16T16:21:07-04:00April 16, 2026|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for April 10

The following is the latest health policy news from the federal government for April 4-10. Some of the language used below is taken directly from government documents. Congress The House and Senate were in recess this week and are scheduled to be back in session on April 14. House Speaker Mike Johnson (R-LA) has indicated that the House will not vote on the Senate‑passed Department of Homeland Security continuing resolution until there is meaningful progress on a reconciliation package to fund U.S. Immigration and Customs Enforcement (ICE) and U.S. Customs and Border Protection. In an effort to narrow the scope [...]

joe2026-04-10T13:43:20-04:00April 10, 2026|340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy|

Medicare Increases Emphasis on Behavioral Health

Medicare policy is evolving to encourage providers to take a more active role in addressing the behavioral health needs of their patients. In traditional Medicare, new payment codes encourage practitioners to spend more time identifying and helping patients with their behavioral health challenges. Meanwhile, CMS and its Center for Medicare and Medicaid Innovation have introduced several new care and payment models that place a greater emphasis on beneficiaries’ behavioral health needs. Among them: The LEAD (Long-Term Enhanced ACO Design) Model, which seeks to include more behavioral health providers and encourages greater integration of behavioral health care. The ACCESS (Advancing Chronic [...]

joe2026-03-31T17:02:07-04:00April 1, 2026|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare|

Federal Health Policy Update for March 26

The following is the latest health policy news from the federal government for March 20-26. Some of the language used below is taken directly from government documents. Congress Republican leadership is exploring a reconciliation bill as a potential vehicle to fund Immigrations and Customs Enforcement (ICE) and pass the Safeguard American Voter Eligibility Act (SAVE) voting rights act. If pursued, this approach could increase the likelihood of additional health care cuts, including expanding site-neutral payment policies in both Medicare and Medicaid. It is not clear whether there will be sufficient support in either chamber for Republicans to pursue a party-line [...]

joe2026-03-26T15:09:34-04:00March 26, 2026|Alternative payment models, Center for Medicare and Medicaid Innovation, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for March 19

The following is the latest health policy news from the federal government for March 13-19. Some of the language used below is taken directly from government documents. The White House President Trump has issued an executive order creating a Task Force to Eliminate Fraud that “…shall, on behalf of the President, coordinate and accelerate a comprehensive national strategy to stop fraud, waste, and abuse within Federal benefit programs, including programs administered jointly with State, local, tribal, and territorial partners.” The vice president will chair the task force, the Secretary of the Department of Health and Human Services is among its [...]

joe2026-03-19T15:41:48-04:00March 19, 2026|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, Medicaid, Medicare, Medicare reimbursement policy|

MedPAC Submits March Report to Congress

As required by law, the Medicare Payment Advisory Commission has submitted its March report to Congress. In this year’s report, MedPAC: evaluates the adequacy of Medicare’s fee-for-service payments and offers its recommendation for changes in the coming year; offers its perspectives on the Medicare Advantage program (Medicare Part C) and the Medicare prescription drug program (Medicare Part D); describes trends and key issues in post-acute care and offers a status report on ambulatory surgical centers; and submits reports mandated by Congress on the performance of special-needs plans for dually eligible (Medicare and Medicaid) beneficiaries and on how changes in the [...]

joe2026-03-12T17:26:14-04:00March 17, 2026|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for March 12

The following is the latest health policy news from the federal government for March 6-12. Some of the language used below is taken directly from government documents. Congress While the House was in recess this week, the Republican caucus held its annual retreat to discuss legislative priorities. Speaker Mike Johnson (R-LA) continues to push for another reconciliation bill, hoping to revisit several proposals to reduce Medicaid spending that were not included in HR another rank-and-file Republicans have expressed doubt that this will be possible. Both chambers of Congress are scheduled to be in session next week. The House Committee on [...]

joe2026-03-12T16:09:44-04:00March 12, 2026|Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicare, Medicare post-acute care, Medicare reimbursement policy|

“Rural Emergency Hospital” Designation Making a Difference for Some Communities

The new (since 2023) classification of some hospitals as “Rural Emergency Hospitals” is proving to be an effective tool for preserving access to care in some rural communities. The program, introduced to help stem the closure of rural hospitals, which was leaving many communities without reasonable access to care, appears to be having the desired effect. Among the benefits reported by the administrators of such hospitals – which must apply for this special federal designation – are preservation of access to emergency and outpatient services, including surgery, laboratory, imaging, and therapy, in communities where they were otherwise in jeopardy; financial [...]

joe2026-03-11T11:18:59-04:00March 12, 2026|340b, hospitals, Medicare|