Medicare

MedPAC Meets

Members of the Medicare Payment Advisory Commission held their latest public meeting on Thursday, October 8 and Friday, October 9. The subjects on the meeting’s agenda were: Issues affecting the payment accuracy of the physician fee schedule and the clinical laboratory fee schedule Clinician quality initiatives in fee-for-service Medicare Medicare’s late-enrollment penalties Workplan: assessing the accuracy of the skilled nursing facility and home health prospective payment systems Go here for a summary of each of these issues, key points, future action items, and links to MedPAC staff presentations. MedPAC is an independent congressional agency that advises Congress on issues involving [...]

joe2026-10-13T15:02:45-04:00October 14, 2026|Medicare, MedPAC|

Federal Health Policy Update for October 8

Don’t Miss: Latest 340B developments CMS penalizes majority of hospitals for failing to meet Readmissions Reduction Program standards FTC reminds hospitals of price transparency requirements The following is the latest health policy news from the federal government for October 2-8. Some of the language used below is taken directly from government documents. The White House The White House announced that the federal government will make one-time payments of $90 per person to more than 20 million Medicare enrollees – about one-third of Medicare participants – to help them pay their Medicare Part B premiums. Most eligible seniors will receive the [...]

joe2026-10-08T16:40:19-04:00October 8, 2026|340b, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for October 1

Don’t Miss: CMS partners with 37 states to launch Medicaid quality initiative CMS fleshes out GLOBE Model Medicare Part D Claims Data 340B Repository goes live The following is the latest health policy news from the federal government for September 25 - October 1. Some of the language used below is taken directly from government documents. The White House A statement issued by the White House titled “President Trump Takes Historic Action to Eliminate Wasteful and Harmful Spending” includes a series of cuts, or rescissions, of health-related federal expenditures, including $567 million for taxpayer-funded HHS services for non-citizens; $28 million [...]

joe2026-10-07T11:45:36-04:00October 1, 2026|340b, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, MACPAC, Medicaid, Medicaid and homelessness, Medicaid regulations, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for September 24

Don’t Miss: CMS plans major cuts in Medicare clinical lab payments Administration reconsiders shifting NIH grant decisions to White House All states enroll in CMS model to reduce prices of selected Medicaid-covered drugs The following is the latest health policy news from the federal government for September 18-24. Some of the language used below is taken directly from government documents. The White House The White House has issued the executive order “Enhancing Program Integrity and Interagency Coordination in the Administration of the H-1B Nonimmigrant Visa Program.” The order increases federal oversight of the H-1B visa program because “The abuse of [...]

joe2026-09-24T15:28:11-04:00September 24, 2026|Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid and homelessness, Medicaid regulations, Medicare, Medicare reimbursement policy|

CMS Eyes Major Cuts in Medicare Clinical Lab Rates

Medicare payments for clinical laboratory services will soon be coming down. The Centers for Medicare & Medicaid Services is working to bring Medicare’s clinical laboratory services rates into line with those paid by commercial insurers. Asserting that Medicare is now paying 16 percent more for clinical lab tests than commercial payers, the agency has posted proposed rates for calendar year 2027 that reflect the beginning of what in some cases will be a multi-year process of aligning public and private lab payments – “aligning” by reducing Medicare payments. Hospital laboratories perform between 40 and 55 percent of laboratory tests. While [...]

joe2026-09-22T17:17:48-04:00September 23, 2026|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for September 17

Don’t Miss: CMS advises on “medical frailty” as qualification for Medicaid eligibility CMS unveils long-anticipated IDR Gateway Medicare ACCESS Model to expand The following is the latest health policy news from the federal government for September 11-17. Some of the language used below is taken directly from government documents. Congress The House Energy & Commerce Committee’s Health Subcommittee held a hearing to discuss bills seeking to modify certain physician payments under Medicare, to address cybersecurity in the health care system, and to expand seniors’ access to care. See the chairman’s opening statement here and find a list of witnesses [...]

joe2026-09-17T16:23:30-04:00September 17, 2026|Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicaid regulations, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for September 10

Don’t Miss: Energy and Commerce to weigh multiple health care bills HRSA shares upcoming 340B administrative changes CMS continues distributing Rural Health Transformation Program $$$ The following is the latest health policy news from the federal government for September 4-10. Some of the language used below is taken directly from government documents. The White House The White House announced that the federal government will issue refunds of $500 a person to nearly one million Americans who it says were overcharged for Affordable Care Act exchange health plans because their premiums included user fees that were charged to cover the cost [...]

joe2026-09-10T14:54:12-04:00September 10, 2026|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, CMMI, Congress, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

MedPAC Meets

Members of the Medicare Payment Advisory Commission held their latest public meeting on Thursday, September 3 and Friday, September 4. The subjects on the meeting’s agenda were: context for Medicare payment policy issues and potential policy directions in Part D workplan: ambulatory surgical centers examining use of post-acute care services by beneficiaries in fee-for-service Medicare and Medicare Advantage Accuracy of Medicare Advantage risk adjustment at the plan level Go here for summaries of the issues and key points and links to the presentations delivered by MedPAC’s staff and go here for a transcript of the two-day session. MedPAC is an independent [...]

joe2026-09-09T12:41:01-04:00September 9, 2026|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Medicare Makes COVID-Era Telehealth Flexibility Permanent

The Centers for Medicare & Medicaid Services has made permanent a change in Medicare telehealth policy that was introduced as a temporary flexibility during the COVID-19 public health emergency: permitting most providers to deliver telehealth services from their homes without listing their home address on their Medicare enrollment. According to the new CMS advisory document “Understanding Telehealth and Teleradiology Enrollment,” If you provide telehealth services from your home, but have a physical practice location, you do not need to report your home address on your Medicare enrollment application. You can enroll and bill from your physical practice location as if [...]

joe2026-09-03T15:06:39-04:00September 8, 2026|Medicare, Telehealth|

Federal Health Policy Update for September 3

Don’t Miss: 340B data reporting requirements for Medicare Part D claims data – repository opens October 1 CMS permanently permits providers to deliver telehealth from home without listing home address on Medicare enrollment application The following is the latest health policy news from the federal government for August 28-September 3. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services (CMS) CMS is preparing to launch a new Medicare Part D Claims Data 340B Repository on October 1. The 340B data repository will be a centralized, federally managed information system that will [...]

joe2026-10-07T11:46:37-04:00September 3, 2026|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, hospitals, Medicaid, Medicare, Medicare regulations, MedPAC, Telehealth|