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 [...]

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 [...]

2022-09-08T06:00:28-04:00September 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 [...]

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 [...]

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 [...]

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 [...]

Federal Health Policy Update for Tuesday, August 2

The following is the latest health policy news from the federal government as of 2:45 p.m. on Tuesday, August 2.  Some of the language used below is taken directly from government documents. White House The White House has announced two new actions to address the youth mental health crisis:  it will award nearly $300 million from the FY 2022 bipartisan omnibus agreement to expand access to mental health services in schools and it will encourage governors to invest more in school-based mental health services.  Learn more about this effort, including the individual funding components of the $300 million in new [...]

Congress Seeks Bigger Bump for Medicare Hospital Payments

More than 140 members of Congress have written to Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure asking her to implement a bigger increase in Medicare payments for hospital inpatient services than the agency has proposed for FY 2023. According to separate bipartisan letters from House and Senate members, the proposed FY 2023 increase – 2.8 percent – fails to reflect inflation and rising health care staffing costs.  The letter signed by 112 House members states that We worry the proposed payment updates do not accurately reflect today’s cost of patient care and, when tethered with other policy changes [...]

Federal Health Policy Update for Wednesday, July 27

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, July 27.  Some of the language used below is taken directly from government documents. Final Medicare Payment Regulations for FY 2023 CMS has issued its final FY 2023 Medicare inpatient rehabilitation facility (IRF) payment system regulation, finalizing a rate increase of 3.9 percent, which is greater than the 2.8 percent the agency proposed in April.  To learn more about CMS’s final IRF payment rule for FY 2023, see this CMS fact sheet and the final rule itself. CMS also has finalized its [...]

Federal Health Policy Update for Wednesday, July 20

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, July 20.  Some of the language used below is taken directly from government documents. White House The White House COVID-19 response team has briefed the press about the administration’s latest efforts in the response to COVID-19.  Find a transcript of that teleconference briefing here. COVID-19 Public Health Emergency HHS Secretary Xavier Becerra has renewed the COVID-19 public health emergency effective July 15. Centers for Medicare & Medicaid Services CMS has released its proposed Medicare outpatient prospective payment system regulation for calendar year 2023.  [...]

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