Medicare regulations

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

Federal Health Policy Update for July 20

The following is the latest health policy news from the federal government for March 13-16.  Some of the language used below is taken directly from government documents. Congress Senator Bernie Sanders (I-VT), chair of the Senate Health, Education, Labor and Pensions (HELP) Committee, has introduced a bill, the “Primary Care and Health Workforce Expansion Act.”  The bill would: Increase funding for community health centers by $65 billion over five years, fund the National Health Service Corps at $8.3 billion over five years, and provide $250 million for HRSA coordination for the Women, Infants, and Children (WIC) program. Add 10,000 graduate [...]

Federal Health Policy Update for July 13

The following is the latest health policy news from the federal government for June 30 – July 13.  Some of the language used below is taken directly from government documents. 340B CMS has published a proposed regulation outlining how it plans to reimburse hospitals for reductions in 340B prescription drug payments that it implemented from 2018 to 2022 but that a federal court found to be illegal.  The agency calculates that it owes participating 340B providers $9 billion, which it proposes paying to those providers in single lump-sum payments.  CMS also proposes offsetting these payments through reductions in future non-drug [...]

Health Policy Update for June 8

The following is the latest health policy news from the federal government for May 28 – June 8.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced a new primary care model – the Making Care Primary Model – that will be tested by the Center for Medicare and Medicaid Innovation in eight states.  The model seeks to improve care for patients by expanding and enhancing care management and care coordination, equipping primary care clinicians with tools to form partnerships with health care specialists, and leveraging community-based connections [...]

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