Medicare

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|

CMS Will Continue Rolling Out Mandatory Models

The Centers for Medicare & Medicaid Services and its Center for Medicare and Medicaid Innovation intend to continue developing and introducing mandatory Medicare models with an emphasis on driving more value-based care. That is the message delivered by CMS administrator Mehmet Oz and CMMI director Abe Sutton during a recent conference. While the track record of CMMI’s models – both voluntary and mandatory – is not great, policymakers believe they remain the best way for government to continue encouraging health care providers to focus more on the delivery of value-based care. To date, only four of the agency’s approximately 50 [...]

joe2026-03-05T17:04:15-05:00March 10, 2026|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare|

MedPAC Posts Agenda for March 2-3 Meeting

The Medicare Payment Advisory Commission has posted the agenda for its next public meeting, which will be held on Monday, March 2 and Tuesday, March 3. The subjects scheduled for consideration during MedPAC’s next two-day session are: mandated report: Assessment of the Medicare ground ambulance data collection system access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease and beneficiaries with cancer provider participation in Medicare Advantage networks considerations for implementing Medicare Advantage encounter data in risk adjustment the complexity of Medicare enrollment decisions for beneficiaries Medicare Part B premium payment basics Go here to see [...]

joe2026-02-26T16:20:05-05:00February 27, 2026|Medicare, Medicare reimbursement policy|

Federal Health Policy Update for February 26

The following is the latest health policy news from the federal government for February 20-26. Some of the language used below is taken directly from government documents. Congress Both chambers of Congress are in session this week and next. The partial shutdown of the Department of Homeland Security that began on February 23 continues. The House Ways and Means Committee held a hearing titled “Advancing the Next Generation of America’s Health Care Workforce” to examine the shortage of resident physicians and explore ways to strengthen rural health care providers and Graduate Medical Education (GME). Watch the hearing and review the witness testimony here. Centers for Medicare & [...]

joe2026-02-26T15:43:01-05:00February 26, 2026|340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|