Medicare regulations

MedPAC Meets, Makes 2025 Payment Recommendations

2025 Medicare payments led the agenda at last week’s meeting of the Medicare Payment Advisory Commission. After hearing presentations on the various Medicare payment systems and discussing the adequacy of current Medicare reimbursement, MedPAC’s commissioners provisionally endorses the following changes in 2025 Medicare payments. Inpatient and outpatient services – an update provided for in current law plus 1.5 percent and a shift to a safety-net index policy that would pay safety-net hospitals another $4 billion. Physicians and other health professionals – an increase of 50 percent of the Medicare economic index and introduction of an add-on payment for services provided [...]

joe2023-12-12T17:52:27+00:00December 13, 2023|hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

Federal Health Policy Update for December 7

The following is the latest health policy news from the federal government for December 1-7. Some of the language used below is taken directly from government documents. Congress While Congress has more than a month before the next federal funding deadline of January 19, committees are working to prepare and pass health care legislation. On the House calendar for floor votes next week is H.R. 5378, the Lower Costs, More Transparency Act. This bill would eliminate the pending cuts to Medicaid DSH for two years (those cuts are temporarily suspended through January 19); introduce site-neutral payments for drug administration services [...]

joe2023-12-07T21:50:17+00:00December 7, 2023|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for November 30

The following is the latest health policy news from the federal government for November 17-30. Some of the language used below is taken directly from government documents. No Surprises Act CMS has released two new FAQs to provide guidance in advance of the Independent Dispute Resolution portal reopening for batched disputes and air ambulance disputes; that service remains temporarily suspended. These FAQs together explain how certified IDR entities may determine whether a dispute is appropriately batched in light of recent court rulings; provide information about policy for extending existing IDR deadlines once the federal IDR portal reopens to all batched [...]

joe2023-11-30T20:59:02+00:00November 30, 2023|Centers for Medicare & Medicaid Services, COVID-19, Federal Update, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for November 16

The following is the latest health policy news from the federal government for November 10-16. Some of the language used below is taken directly from government documents. Congress This week Congress passed another continuing resolution (CR) to fund the federal government beyond Friday, when the current CR expires. This bill establishes two separate deadlines for lawmakers to pass certain spending bills so they can avoid an omnibus bill that includes all 12 appropriations bills. Congress must pass four of the spending bills by January 19 and the other bills by February 2. The Labor, HHS, and Education bill, one of [...]

Federal Health Policy Update for November 9

The following is the latest health policy news from the federal government for November 3-9. Some of the language used below is taken directly from government documents. Congress Senate Finance Committee Earlier this week the Senate Finance Committee passed the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023. The bill, which passed out of the committee by a vote of 26-0, would: eliminate $16 billion in cuts to Medicaid DSH for 2024 and 2025; soften the 2024 cut to Medicare physician payments by reducing the conversion factor by 2.15 percent rather than the 3.4 percent that CMS [...]

admin2023-11-09T15:41:22+00:00November 9, 2023|340b, Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for October 5

The following is the latest health policy news from the federal government for September 29 to October 5. Some of the language used below is taken directly from government documents. Congress Last Saturday, Congress passed a 45-day continuing resolution (CR) to fund the federal government through November 17. Part of that limited CR includes a delay of the scheduled $8 billion cut to Medicaid DSH allotments to states through the end of the CR. The bill also extends funding for community health centers and the National Health Services Corps for the same length of time. Congress will have to act [...]

admin2023-10-05T14:53:32+00:00October 5, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for September 7

The following is the latest health policy news from the federal government for September 1-7. Some of the language used below is taken directly from government documents. Congress House Republicans plan to introduce the Lower Cost, More Transparency Act for consideration before the end of the year. This bill includes provisions passed by three committees with health care jurisdiction: House Ways & Means, Energy & Commerce, and Education & Workforce. Some of the bill’s provisions would: eliminate scheduled Medicaid DSH cuts for FY 2024 and FY 2025; reauthorize and extend funding for the Community Health Center program, the National Health [...]

admin2023-09-07T16:39:42+00:00September 7, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|

Hospitals Continue to Protest Medicare DSH Cut

The regulation has already been finalized but hospitals continue to protest Medicare’s intention to reduce their Medicare disproportionate share (Medicare DSH) uncompensated care payments. The cut, proposed at $115 million in April, when the Centers for Medicare & Medicaid Services proposed it, ended up just shy of $1 billion in the final regulation. The major change, according to CMS, comes because the agency’s actuaries have projected a lower uninsured rate than when CMS proposed the $115 million cut in the spring. Medicare DSH payments are intended to help hospitals that care for especially large numbers of uninsured patients with the [...]

admin2023-08-17T06:00:38+00:00August 17, 2023|Centers for Medicare & Medicaid Services, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for August 3

The following is the latest health policy news from the federal government for July 29-August 3. Some of the language used below is taken directly from government documents. Medicare Payment Regulations CMS has issued a final rule updating Medicare payment policies and rates for inpatient and long-term-care hospital services under its inpatient prospective payment system and long-term care prospective payment system for FY 2024. The final rule increases hospital inpatient rates 3.1 percent and LTCH rates 3.3 percent in FY 2024. Other highlights include a nearly $1 billion cut in Medicare disproportionate share (Medicare DSH) and Medicare DSH uncompensated care [...]

admin2023-08-03T15:28:05+00:00August 3, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for July 28

The following is the latest health policy news from the federal government for July 21 -28. Some of the language used below is taken directly from government documents. Medicare Payment Regulations CMS has published a final rule to update Medicare payment policies and rates under its inpatient rehabilitation facility (IRF) prospective payment system and IRF quality reporting program for FY 2024. The final rule includes a 3.4 percent rate increase and changes in the outlier threshold, the case-mix-group relative weights and average length of stay values, and the wage index. In addition, this rule rebases and revises the IRF market [...]

admin2023-07-28T14:28:17+00:00July 28, 2023|Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|