Medicare reimbursement policy

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 The White House The White House has rescinded Executive Order 13994 of January 21, 2021, titled “Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats.” In response to this action, CMS rescinded its November 22, 2022 memo “The Importance of Timely Use of COVID-19 Therapeutics,” the purpose of which, according the memo, was “…to highlight the importance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|

Federal Health Policy Update for March 6

The following is the latest health policy news from the federal government for March February 28 – March 6. Some of the language used below is taken directly from government documents. Congress The current continuing resolution funding the federal government expires on March 14. Leaders intend to propose a long-term continuing resolution through the end of the current federal fiscal year in September. The likelihood of success of that approach is uncertain. Separately, a number of health care extenders, including preventing cuts to Medicaid disproportionate share (Medicaid DSH), an extension of telehealth flexibilities, an extension of the Acute Hospital Care [...]

joe2025-03-06T16:39:50-05:00March 6, 2025|Centers for Medicare & Medicaid Services, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for February 27

The following is the latest health policy news from the federal government for February 21-27. Some of the language used below is taken directly from government documents. Congress The current continuing resolution funding the federal government expires on March 14. Separately, a number of health care extenders, including preventing cuts to Medicaid disproportionate share (Medicaid DSH), an extension of telehealth flexibilities, an extension of the Acute Hospital Care at Home program, and other rural programs, will expire on March 31. Also, provisions that had been included in the bipartisan health care package proposed in December, including PBM reform, the package [...]

joe2025-02-27T16:26:33-05:00February 27, 2025|Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare reimbursement policy, social determinants of health|

Federal Health Policy Update for February 13

The following is the latest health policy news from the federal government for February 7 - 13. Some of the language used below is taken directly from government documents. Introduction With the pause in external communication that the new administration imposed on HHS three weeks ago, including announcements, advisories, regular publications, and web site updates, there has been very little public communication from or activity involving HHS in the past week. While an HHS spokesperson explained that the moratorium has been eased and agencies are now permitted to engage in some public communication, subject to review, such activity remains very [...]

Hospitals Chart 2025 Public Policy Objectives

The hospital industry has an ambitious public policy agenda for 2025 – most of it involving defending the status quo against proposed changes. Hospitals’ advocacy in 2025 will focus on: Fighting off Medicaid cuts, work requirements, reductions in the federal Medicaid matching rate, eliminating scheduled cuts in Medicaid disproportionate share (Medicaid DSH) allotments to the states, and protecting state-directed Medicaid payments and the ability of states to raise Medicaid funding through provider taxes. Preventing a transition to site-neutral payments for Medicare-covered outpatient services. Ensuring the continuation of current section 340B prescription drug discount program practices. Preserving and even extending current [...]

joe2025-02-12T11:11:23-05:00February 13, 2025|340b, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for January 23

The Administration Public Communication The new administration has directed HHS to pause all external communications, including announcements, advisories, regular publications, and web site updates. According to a published report, "HHS has issued a pause on mass communications and public appearances that are not directly related to emergencies or critical to preserving health," a spokesperson wrote in an email. "This is a short pause to allow the new team to set up a process for review and prioritization. There are exceptions for announcements that HHS divisions believe are mission critical, but they will be made on a case-by-case basis." The directive [...]

MedPAC Meets

MedPAC’s commissioners held their latest public meetings on Thursday, January 13 and Friday, January 14. The subjects on the meetings’ agenda were: assessing payment adequacy and updating payments: physician and other health professional services assessing payment adequacy and updating payments: hospital inpatient and outpatient services assessing payment adequacy and updating payments: skilled nursing facility services; home health agency services; inpatient rehabilitation facility services; outpatient dialysis services; and hospice services eliminating Medicare’s coverage limits on stays in freestanding inpatient psychiatric facilities Medicare prescription drug program (Part D): status report ambulatory surgical center services: status report the Medicare Advantage program: status report [...]

joe2025-01-21T17:23:04-05:00January 22, 2025|Centers for Medicare & Medicaid Services, Federal Update, hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for January 16

The following is the latest health policy news from the federal government for January 11-17. Some of the language used below is taken directly from government documents. Congress House Budget Committee Republican members of the House Budget Committee have circulated a list of possible policy changes that would reduce federal spending by between $5.3 trillion and $5.7 trillion over a period of ten years. Up to $3.4 trillion of those possible cuts could include reductions in federal health care spending. The health care cuts the document lists (all figures are ten-year reductions) are: Medicare introducing Medicare site-neutral outpatient payments - [...]