Medicare reimbursement policy

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 [...]

2025-02-27T16:26:33-05:00February 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|
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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 [...]

2025-02-13T15:23:17-05:00February 13, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|
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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 [...]

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

2025-01-23T14:37:57-05:00January 23, 2025|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, COVID-19, Federal Update, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare bad debt reimbursement, Medicare cuts, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Pennsylvania Update|
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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 [...]

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

2025-01-16T16:45:18-05:00January 16, 2025|Accountable Care Organization, ACO, Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, Federal Update, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare bad debt reimbursement, Medicare cuts, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, Pennsylvania Update, Telehealth|
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House Committee Mulls Possible Health Care Cuts

Republican members of the House Budget Committee have circulated a list of possible policy changes that would reduce federal spending 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 - $146 billion reducing Medicare disproportionate share (Medicare DSH) uncompensated care payments - $229 billion reducing Medicare bad debt reimbursement - $42 billion extending the Bipartisan Budget Act of 2013 budget sequestration that [...]

2025-01-14T15:44:54-05:00January 15, 2025|Affordable Care Act, Congress, deficit reduction, Federal Update, hospitals, Medicaid, Medicare, Medicare bad debt reimbursement, Medicare cuts, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy, Pennsylvania Update|
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Federal Health Policy Update for January 9

The following is the latest health policy news from the federal government for January 4-10.  Some of the language used below is taken directly from government documents. Congress  Congressional leaders continued to refine their committee membership for the 119th Congress.  In the past week, the following additions were made to committees with jurisdiction over health care matters: The House Energy and Commerce Committee has added six new Democratic members to the committee:  Reps. Kevin Mullin (CA), Troy Carter (LA), Jennifer McClellan (VA), Greg Landsman (OH), Jake Auchincloss (MA), and Alexandria Ocasio-Cortez (NY). The House Ways and Means Committee has added [...]

2025-01-09T15:02:36-05:00January 9, 2025|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Federal Update, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy|
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Federal Health Policy Update for December 19

The following is the latest health policy news from the federal government for December 13-19.  Some of the language used below is taken directly from government documents. Congress Funding for the operation of the federal government will expire tomorrow, December 20, unless Congress passes a funding bill.  Earlier this week, congressional leaders agreed on a continuing resolution that included a number of health care priorities, including relief from scheduled Medicaid DSH cuts, relief for Medicare physician payment cuts, extension of telehealth flexibilities, extension of the Acute Hospital Care at Home program, a number of changes in the practices of pharmacy [...]

2024-12-19T16:06:57-05:00December 19, 2024|340b, Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare reimbursement policy, MedPAC, Telehealth|
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MedPAC Meets, Offers Preliminary 2026 Rate Proposals

MedPAC’s commissioners held their latest public meeting on Thursday, December 12 and Friday, December 13.  The subjects on the meeting’s 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; and mandated report on rural emergency hospitals assessing payment adequacy and updating payments: skilled nursing facility services assessing payment adequacy and updating payments: inpatient rehabilitation facility services assessing payment adequacy and updating payments: home health care services assessing payment adequacy and updating payments: hospice services assessing payment adequacy and updating payments: outpatient dialysis services In [...]

2024-12-17T13:33:44-05:00December 17, 2024|Centers for Medicare & Medicaid Services, hospitals, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, MedPAC|
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