Medicare regulations

Federal Health Policy Update for May 17

The following is the latest health policy news from the federal government for May 10-17.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced a further extension of deadlines for fulfilling certain Medicaid unwinding requirements.  Some current deadlines will be extended to December 31, 2024 and others through June 30, 2025.  States also may seek to extend selected COVID-19-related flexibilities through June 30, 2025.  Among the deadlines affected by this announcement are those for using ex parte information to determine eligibility; permitting Medicaid managed care organizations to help [...]

Federal Health Policy Update for May 2

The following is the latest health policy news from the federal government for April 26 – May 2.  Some of the language used below is taken directly from government documents. No Surprises Act – Independent Dispute Resolution Process CMS has announced a new process for resubmitting Independent Dispute Resolution (IDR) disputes that were originally improperly batched or bundled.This new resubmission process is automated in the federal IDR portal and seeks to streamline federal IDR operations.  For further information about this new process and an implementation timetable, see this CMS announcement.  CMS also has posted a user guide for the IDR [...]

Federal Health Policy Update for April 25

The following is the latest health policy news from the federal government for April 9-25.  Some of the language used below is taken directly from government documents. Updated 340B Arbitration Process Last week HHS’s Health Resources and Services Administration (HRSA) published a regulation modifying the administrative dispute resolution (ADR) process it uses to adjudicate payment disputes between 340B-eligible providers and pharmaceutical companies.  The major changes in the ADR process include the use of HRSA experts to serve on ADR panels; elimination of the $25,000 damage threshold for filing a claim; 340B-eligible providers may now challenge manufacturers that seek to prevent [...]

Federal Health Policy Update for April 18

The following is the latest health policy news from the federal government for April 12-18.  Some of the language used below is taken directly from government documents. The White House The administration has launched a new global health security strategy that seeks to drive action across federal departments and agencies and rally support from other countries, the private sector, and civil society to better prevent, detect, respond to, and recover from infectious disease threats.  The strategy seeks to build on the lessons learned from the response to the COVID-19 pandemic.  Learn more from this White House statement; the administration’s strategy [...]

Federal Health Policy Update for April 12

The following is the latest health policy news from the federal government for April 5-11.  Some of the language used below is taken directly from government documents. CMS – Proposed FY 2025 Medicare Inpatient Prospective Payment System Regulation Earlier this week CMS issued its proposed FY 2025 Medicare inpatient prospective payment system regulation – the rule under which it envisions paying acute-care hospitals, critical access hospitals, and long-term care hospitals for inpatient care in the coming fiscal year.  Highlights of the proposed rule include: Rate increases of 2.6 percent for acute-care and critical access hospitals and 2.8 percent for LTCHs. [...]

Federal Health Policy Update for April 4

The following is the latest health policy news from the federal government for March 29 – April 4.  Some of the language used below is taken directly from government documents. The White House The White House has announced that the Office of Management and Budget (OMB) has issued a government-wide policy to attempt to mitigate the risks of artificial intelligence (AI) and harness its benefits.  The order directs action to strengthen AI safety and security, protect privacy, advance equity and civil rights, stand up for consumers and workers, and promote innovation and competition.  It includes components on addressing risks from [...]

Federal Health Policy Update for March 28

The following is the latest health policy news from the federal government for March 22-28.  Some of the language used below is taken directly from government documents. The Cyberattack on Change Healthcare HHS, its Administration for Strategic Preparedness and Response, and CMS have published a resource guide for providers seeking assistance in response to the Change Healthcare cyberattack.  Find that guide here. Centers for Medicare & Medicaid Services CMS has issued a proposed rule to update Medicare payment policies and rates under its Inpatient Rehabilitation Facility (IRF) Prospective Payment System and the IRF Quality Reporting Program (QRP) for FY 2025.  The proposed rule [...]

Federal Health Policy Update for March 21

The following is the latest health policy news from the federal government for March 15-21.  Some of the language used below is taken directly from government documents. The White House The White House has announced new actions to advance women’s health research and innovation and issued an executive order in support of that objective.  The order directs executive branch agencies to integrate women’s health across the federal research portfolio; prioritize investments in women’s health research; pursue new research on women’s midlife health; and assess unmet needs to support women’s health research.  Learn more from this White House fact sheet, which [...]

MedPAC Recommends Medicare Rate Updates to Congress

Some health care providers deserve larger Medicare payments in 2025, some should receive payment cuts, and others should see their payments go unchanged according to new recommendations from the Medicare Payment Advisory Commission to Congress. In its annual report to Congress, MedPAC recommended the following changes in Medicare rates for 2025: Medicare inpatient rates – the rate increase currently scheduled by law for 2025 plus 1.5 percent. Medicare outpatient rates – the rate increase currently scheduled by law for 2025 plus 1.5 percent. Medicare physician rates – the rate increase for physician and other health professional services currently scheduled by [...]

Federal Health Policy Update for March 7

The following is the latest health policy news from the federal government for March 1-7.  Some of the language used below is taken directly from government documents. Congress On Wednesday, March 16 the House passed, by a vote of 339-85, the first package of spending bills to fund some federal agencies through the remainder of the 2024 federal fiscal year.  The House bills include several health care provisions extending programs that were set to expire on Friday, March 8.  The bills would extend the following provisions and programs through December 31, 2024: The continued delay of cuts to Medicaid disproportionate [...]

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