Medicare

Federal Health Policy Update for May 22

The following is the latest health policy news from the federal government for May 16-22. Some of the language used below is taken directly from government documents. Congress: Reconciliation Early Thursday morning the House of Representatives passed its version of an FY 2025 budget reconciliation bill by a vote of 215-214. The bill underwent a number of changes during the hours before its passage and its health care provisions now include $800 billion in Medicaid cuts over the next ten years. The Congressional Budget Office projects that the bill, mostly because of the Medicaid cuts, will lead to 8.6 million [...]

joe2025-05-23T10:22:33-04:00May 23, 2025|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, COVID-19, deficit reduction, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

Innovation Center to Steer New Course

The Centers for Medicare & Medicaid Services’ Center for Medicare and Medicaid Innovation has announced that it will take a new approach to developing and testing new models of health care delivery – an approach designed to be more MAHA-oriented. The Innovation Center intends to place a greater emphasis on disease and chronic condition prevention built around what it calls “three interrelated pillars:” promoting evidence-based prevention, empowering people to achieve their health goals, and driving choice and competition. The agency says it “…will focus on models that show the greatest promise for generating savings and improving quality.” Specifically, the Innovation [...]

joe2025-05-15T16:13:40-04:00May 19, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare|

Federal Health Policy Update for May 15

The following is the latest health policy news from the federal government for May 9-15. Some of the language used below is taken directly from government documents. Congress: Reconciliation House Energy and Commerce Committee Charged with finding $880 billion in federal spending cuts over the next ten years, the House Energy and Commerce Committee this week produced legislative language to be included in a House reconciliation bill that would achieve that objective. The committee’s cost-cutting provisions include: Freezing state Medicaid provider taxes at their current level, prohibiting the establishment of new provider taxes, modifying the criteria CMS uses to determine [...]

joe2025-05-15T17:19:56-04:00May 15, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, deficit reduction, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations, Medicare, Medicare cuts, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for May 8

The following is the latest health policy news from the federal government for May 2-8. Some of the language used below is taken directly from government documents. Congress Reconciliation Over the past several days the political gravity surrounding Medicaid cuts has begun to shift slightly. Moderate Republicans have been pushing back more forcefully and more loudly against such cuts, with some saying they will not support more than work requirements and increased enforcement checks for eligibility. Opposition to most Medicaid cuts led the Energy and Commerce Committee to delay a markup of its reconciliation bill planned for this week to [...]

joe2025-05-08T16:50:48-04:00May 8, 2025|Accountable Care Organization, Alternative payment models, Congress, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

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|