Medicare

Federal Health Policy Update for May 1

The following is the latest health policy news from the federal government for April 25 – May 1. Some of the language used below is taken directly from government documents. Congress Reconciliation The House and Senate returned to Washington D.C. this week and House committees have begun marking up reconciliation legislation for submission to the House Budget Committee by May 9. The Energy and Commerce Committee is expected to seek nearly $550 billion in cuts to Medicaid spending and the most likely targets for cuts continue to be work requirements for Medicaid eligibility; more frequent review of Medicaid eligibility; reducing the federal [...]

joe2025-05-01T15:33:24-04:00May 1, 2025|Centers for Medicare & Medicaid Services, Congress, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for April 24

The following is the latest health policy news from the federal government for April 18-24. Some of the language used below is taken directly from government documents. Congress The House and Senate are in recess until April 28. Upon their return to Washington D.C., committees will begin marking up reconciliation legislation for submission to their respective chambers’ budget committees by May 9. The Energy and Commerce Committee is expected to mark up its bill, with $880 billion in cuts, the week of May 5. The committee is expected to seek nearly $550 billion in cuts to Medicaid spending, with the [...]

joe2025-04-24T14:45:26-04:00April 24, 2025|340b, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicaid managed care, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for April 17

The following is the latest health policy news from the federal government for April 11-17. Some of the language used below is taken directly from government documents. The White House President Trump signed an executive order titled “Lowering Drug Prices by Once Again Putting Americans First” that directs the Secretary of the Department of Health and Human Services to take steps to lower prescription drug costs for patients. The order addresses several prescription drug-related policies, including: the Medicare Drug Price Negotiation Program seeking better Medicare prices for drugs not subject to the Medicare Drug Price Negotiation Program accelerating FDA drug [...]

joe2025-04-17T17:14:31-04:00April 17, 2025|340b, Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, 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 today passed the budget resolution passed by the Senate last week. Passage of the same budget resolution by both chambers now enables Congress to begin work on a reconciliation bill to enact President Trump’s priorities on tax cuts, border security, and energy policies. Until this morning, more than a dozen Republican House members had opposed the Senate-passed budget resolution because they believed the Senate’s budget did not require enough spending [...]

joe2025-04-10T16:05:02-04:00April 10, 2025|Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

HHS to Reorganize

The federal Department of Health and Human Services has announced a major restructuring of its operations. The changes include: Terminating an additional 10,000 of the agency’s employees, over and above 10,000 employee reduction that already has taken place, thereby reducing its staff from 82,000 to 62,000 full-time employees. The terminations include: 300 full-time employees at CMS, with HHS noting that this “…will not impact Medicare and Medicaid.” 3500 at the FDA, with HHS explaining that this reduction “…will not affect drug, medical device, or food reviewers, nor will it impact inspectors.” 1200 at the NIH. 2400 at the CDC. Reducing [...]

joe2025-03-27T16:30:58-04:00March 31, 2025|Medicaid, Medicare|

Federal Health Policy Update for March 27

The following is the latest health policy news from the federal government for March 21-27. Some of the language used below is taken directly from government documents. Congress The House and Senate need to pass a joint budget resolution as a first step before committees can begin writing legislation to pass under reconciliation. Each chamber has passed its own budget resolution and while the two are very different, congressional leaders have agreed to write a less prescriptive resolution that will permit each chamber’s committees to determine the level of spending and saving required and then will try to work out [...]

joe2025-03-27T17:03:07-04:00March 27, 2025|Centers for Medicare & Medicaid Services, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

MedPAC Makes 2026 Medicare Rate Recommendations

The Medicare Payment Advisory Commission recently released “Report to the Congress: Medicare Payment Policy,” its required March report to Congress. In addition to addressing a variety of Medicare issues, MedPAC presented its 2026 Medicare rate recommendations to Congress. Those recommendations are: Hospital inpatient and outpatient services – the rate increase in current law plus one percent. MedPAC also reiterated its past recommendation that Medicare redistribute current Medicare disproportionate share (Medicare DSH) and uncompensated care payments through MedPAC’s own mechanism, the Medicare Safety-Net Index (MSNI) it introduced in 2023, maintaining that doing so, when supplemented with an additional $4 billion in [...]

joe2025-03-20T14:44:09-04:00March 25, 2025|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for March 20

The following is the latest health policy news from the federal government for March 14-20. Some of the language used below is taken directly from government documents. The White House The White House has rescinded Executive Order 13994 of January 21, 2021, titled “Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats.” In response to this action, CMS rescinded its November 22, 2022 memo “The Importance of Timely Use of COVID-19 Therapeutics,” the purpose of which, according the memo, was “…to highlight the importance of providing timely access to available COVID-19 therapeutics to patients who test positive [...]

joe2025-03-20T16:00:25-04:00March 20, 2025|340b, Centers for Medicare & Medicaid Services, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for March 13

The following is the latest health policy news from the federal government for March 7-13. Some of the language used below is taken directly from government documents. Congress Funding the Federal Government Unless Congress passes spending legislation, funding for the federal government will expire at 12:01 a.m. this Saturday, March 15. This week, the House passed a continuing resolution that would fund the federal government through the end of the 2025 federal fiscal year. The bill extends telehealth flexibilities, the Acute Hospital Care at Home program, and other health extenders through September 30, 2025. The bill also delays cuts to [...]

joe2025-03-13T15:54:07-04:00March 13, 2025|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid long-term services and supports, Medicaid regulations, Medicare, Medicare reimbursement policy, Telehealth|

MedPAC Meets

MedPAC’s commissioners held their latest public meetings on Thursday, March 6 and Friday, March 7. The subjects on the meetings’ agenda were: reforming Medicare physician fee schedule updates and improving the accuracy of relative payment rates reducing beneficiary cost-sharing for Medicare-covered outpatient services at critical access hospitals Medicare insurance agents Medigap mandated report: payment for ground ambulance services examining home health care use among Medicare Advantage enrollees institutional special needs plans reducing beneficiary cost-sharing for Medicare-covered outpatient services at critical access hospitals Go here for summaries of the issues and key points and links to the presentations delivered by MedPAC staff and [...]

joe2025-03-11T10:52:28-04:00March 12, 2025|Medicare, Medicare reimbursement policy, MedPAC|