Medicare reimbursement policy

FEDERAL HEALTH POLICY UPDATE FOR OCTOBER 13

The following is the latest health policy news from the federal government for the week of October 7 to October 13. Some of the language used below is taken directly from government documents. Public Health Emergency Declaration HHS Secretary Becerra has renewed the COVID-19 Public Health Emergency declaration. This renewal does not provide the promised 60-day notice of the PHE’s end, so for now, the current declaration is set expire on January 11, 2023. We will continue to update you on any changes to the PHE timeline. You can view the PHE renewal here. White House The White House COVID-19 [...]

iqtsupport2022-10-13T17:14:18-04:00October 13, 2022|Centers for Medicare & Medicaid Services, COVID-19, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for October 6

The following is the latest health policy news from the federal government for the week of September 26 to October 6. Some of the language used below is taken directly from government documents. 340B HHS must immediately end its significant cut in reimbursement for 340B-covered prescription drugs provided on an outpatient basis to eligible patients, a federal court has ruled, writing that “The prospective portion of the 2022 reimbursement rate shall be vacated because it is defective and because vacating this portion of the 2022 OPPS Rule will not cause substantial disruption” and that “HHS should not be allowed to [...]

iqtsupport2022-10-06T17:42:49-04:00October 6, 2022|340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

FEDERAL HEALTH POLICY UPDATE FOR THE WEEK OF SEPTEMBER 19-27

The following is the latest health policy news from the federal government for the week of September 19-27. Some of the language used below is taken directly from government documents. White House The White House has issued a fact sheet summarizing new actions and funding to address the overdose epidemic and support recovery as part of its September “National Recovery Month.” Awarding $1.5 billion for all states and territories to address addiction and the opioid crisis. Investing more than $104 million to expand substance use treatment and prevention in rural communities. Investing $20.5 million to increase access to recovery supports. [...]

iqtsupport2022-09-27T17:09:35-04:00September 27, 2022|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare reimbursement policy|

Risk Adjustment Has Impact on Medicare Readmissions Program

The use of social risk adjustment has helped reduce differences in the penalties assessed to safety-net hospitals and other hospitals by Medicare’s hospital readmissions reduction program, according to a new study. According to the study published in the journal Health Affairs, Seven studies found that adding social risk factors to the program’s base risk-adjustment model (which adjusts only for age, sex, and comorbidities) reduced differences in risk-adjusted readmissions and penalties between safety-net hospitals and other hospitals. Three studies found that peer grouping, the HRRP’s current approach to social risk adjustment, reduced penalties among safety-net hospitals. Two studies found that differences [...]

iqtsupport2022-09-22T06:00:18-04:00September 22, 2022|Medicare, Medicare reimbursement policy|

FEDERAL HEALTH POLICY UPDATE FOR THE WEEK OF SEPTEMBER 12-16

The following is the latest health policy news from the federal government for the week of September 12-16. Some of the language used below is taken directly from government documents. No Surprises Act The Department of Health and Human Services, the federal Office of Personnel Management, the Internal Revenue Service, the Department of the Treasury, the Department of Labor, and the Employee Benefits Security Administration have issued a request for information (RFI) seeking stakeholder comment on how to implement the No Surprises Act’s requirement that health care providers and payers give explanations of benefits and good-faith estimates of costs for [...]

iqtsupport2022-09-19T16:10:33-04:00September 19, 2022|340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

MedPAC Meets

The Medicare Payment Advisory Commission held public meetings on September 1 and 2. Among the subjects discussed during the meeting were: Reforming Medicare’s wage index system – “the commission remains concerned about Medicare’s current wage index policies, including the system’s inaccuracy, the circularity of hospital-reported data, the large volume of permitted exceptions, and administrative complexity and MedPAC commissioners discussed an alternative wage index methodology.” Context for Medicare payment policy – an annual discussion. Standardizing benefits in Medicare Advantage plans – cost sharing for Part A and Part B services Medicare Advantage encounter data – “MedPAC has been concerned about the [...]

iqtsupport2022-09-08T06:00:28-04:00September 8, 2022|Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for the Week of August 24 to September 2

The following is the latest health policy news from the federal government for the week of August 29 to September 2. Some of the language used below is taken directly from government documents. The White House The White House has introduced a new “National HIV Strategy” for 2022-2025. The new strategy updates the 2021 strategy and establishes targets for ending the HIV epidemic in the U.S. by 2030, including a 75 percent reduction in new HIV infections by 2025 and a 90 percent reduction by 2030. Find the strategy here. Proposed Changes in Medicaid, CHIP, and Basic Health Program Enrollment [...]

iqtsupport2022-09-06T15:25:17-04:00September 6, 2022|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|

Federal Health Policy Update for Tuesday, August 23

The following is the latest health policy news from the federal government as of 2:45 p.m. on Tuesday, August 23. Some of the language used below is taken directly from government documents. CMS “Roadmap for the End of the COVID-19 Public Health Emergency” While the COVID-19 public health emergency (PHE) has not ended and HHS Secretary Becerra has committed to giving states and the health care community 60 days’ notice before formally ending it – notice he has not given – the federal government is already planning for life after the PHE and its latest step in this process is [...]

iqtsupport2022-08-23T17:33:16-04:00August 23, 2022|Centers for Medicare & Medicaid Services, COVID-19, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|

Federal Health Policy Update for Monday, August 8`

The following is the latest health policy news from the federal government as of 2:30 p.m. on Monday, August 8. Some of the language used below is taken directly from government documents. Congress On Sunday, the Senate passed the Democrats’ health care, climate, and tax bill, H.R. 5376, The Inflation Reduction Act, by a vote of 51-50, with Vice President Harris casting the tie-breaking vote. Health care provisions in the reconciliation bill include: allowing Medicare to negotiate prescription drug prices limiting out-of-pocket prescription drug costs for Medicare enrollees to $2,000 a year extending for three years enhanced Affordable Care Act [...]

iqtsupport2022-08-08T16:12:06-04:00August 8, 2022|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, COVID-19, deficit reduction, Medicaid, Medicare reimbursement policy, Telehealth|

On Second Thought, CMS Decides to Share Hospital Performance Data

After originally proposing not to publish certain recent hospital performance data because it feared it might be skewed by COVID-19-related challenges, the Centers for Medicare & Medicaid Services has decided to go ahead and publish that data – but not to use it in Medicare payment calculations. Under Medicare’s hospital-acquired condition program, hospitals are rated on their performance on ten safety indicators. Regulators, however, feared that doing so based on hospital performance during the pandemic might penalize hospitals whose communities were especially hard hit by the pandemic. Patient safety groups opposed CMS’s April proposal to withhold the data and the [...]

iqtsupport2022-08-05T09:04:52-04:00August 5, 2022|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare reimbursement policy|