Medicare reimbursement policy

Federal Health Policy Update for February 1

The following is the latest health policy news from the federal government for January 26 – February 1. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has released its calendar year (CY) 2025 Advance Notice for the Medicare Advantage and Medicare Part D Prescription Drug Programs that would update payment and other policies for these programs. Under the notice, federal Medicare Advantage spending would increase an expected 3.7 percent, or more than $16 billion, but the agency also proposes reducing by 0.16 percent the program’s base rate. CMS also detailed [...]

joe2024-02-01T21:47:38+00:00February 1, 2024|Accountable Care Organization, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Federal Update, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for January 25

The following is the latest health policy news from the federal government for January 12 - 25. Some of the language used below is taken directly from government documents. Department of Health and Human Services – Funding Models HHS has announced a new model to test approaches for addressing the behavioral and physical health and health-related social needs of people with Medicaid and Medicare. The goal of the Innovation in Behavioral Health Model (IBH) is to improve the overall quality of care and outcomes for adults with mental health conditions and/or substance use disorders by connecting them with the physical, behavioral, [...]

joe2024-01-25T22:30:26+00:00January 25, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health, Telehealth|

Federal Health Policy Update for January 18

The following is the latest health policy news from the federal government for January 12-16. Some of the language used below is taken directly from government documents. Congress Medicaid DSH With a partial government shutdown looming on Friday, January 19, congressional leaders have agreed to extend the current stopgap legislation temporarily funding the federal government. Under this agreement, the four spending bills scheduled to expire this Friday would be extended until March 1 and the eight bills set to expire on February 2 would be extended until March 8. The appropriations bill that funds health and human services is included [...]

joe2024-01-17T18:49:52+00:00January 18, 2024|hospitals, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

MedPAC Meets, Finalizes 2025 Payment Recommendations

2025 Medicare payments led the agenda at last week’s meeting of the Medicare Payment Advisory Commission. After hearing presentations on the various Medicare payment systems and discussing the adequacy of current Medicare reimbursement, MedPAC’s commissioners voted to recommend the following changes in 2025 Medicare payments. Inpatient and outpatient services – an update provided for in current law plus 1.5 percent and a shift to a safety-net index policy that would pay safety-net hospitals another $4 billion. Physicians and other health professionals – an increase of 50 percent of the Medicare economic index and introduction of an add-on payment for services [...]

joe2024-01-16T14:22:30+00:00January 16, 2024|hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

Federal Health Policy Update for January 11

The following is the latest health policy news from the federal government for January 5 - 11. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS will establish 200 new Medicare-funded residency slots in FY 2025. Learn more about the additional slots here and find information about how to apply for those slots here. The deadline for applications is March 31. CMS released guidance for Medicare Part D plans that describes coverage and processing claims for COVID-19 therapeutics. Medicare Part D plans must cover commercially available oral antivirals for COVID-19 [...]

joe2024-01-11T21:27:47+00:00January 11, 2024|hospitals, MACPAC, Medicaid, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for January 4

The following is the latest health policy news from the federal government for December 21 to January 4. Some of the language used below is taken directly from government documents. No Surprises Act HHS, the departments of Labor and the Treasury, and the Office of Personnel Management intend to reopen the comment period for submitting comments on a proposed rule governing federal Independent Dispute Resolution (IDR) operations. They plan to publish a notice to this effect in the near future with further details on reopening the comment period. Department of Health and Human Services HHS’s Office of the National Coordinator [...]

joe2024-01-04T22:10:23+00:00January 4, 2024|Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, Federal Update, health equity, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Expanded Mental Health Options Coming to Medicare

Beginning on January 1, Medicare beneficiaries will have access to more varied types of mental health services. At that time, mental health counselors and marriage and family therapists will become eligible to accept Medicare payments, joining the limited number of psychiatrists, psychologists, and social workers who have been serving the Medicare population as part of the first expansion of Medicare-eligible mental health providers since 1989. With Medicare planning to pay its new provider types 75 percent of what it pays psychologists, it is not clear how many of those new providers will be interested in enrolling as eligible Medicare providers. [...]

joe2023-12-21T15:22:53+00:00December 26, 2023|Medicare, Medicare reimbursement policy|

Federal Health Policy Update for December 20

The following is the latest health policy news from the federal government December 14-20. Some of the language used below is taken directly from government documents. Congress The House is in recess until January 9. The Senate has delayed its recess to continue negotiations on a possible foreign aid and border policy deal. Democrats from the House Ways and Means Committee have published a report on the relationship between the U.S. health care system and climate change. View their report “Health Care and the Climate Crisis: Preparing America’s Health Care Infrastructure.” No Surprises Act The federal government has reopened the [...]

Federal Health Policy Update for December 14

The following is the latest health policy news from the federal government for December 8-14. Some of the language used below is taken directly from government documents. MedPAC Rate Recommendations At their latest public meeting, members of the Medicare Payment Advisory Commission voted preliminary approval of the following rate updates for 2025 Medicare payments: Inpatient and outpatient services –update provided for in current law plus 1.5% and adoption of a safety-net index policy to pay safety-net hospitals another $4 billion. Physicians and other health professionals –update of 50% of the Medicare economic index and a new add-on payment for services [...]

joe2023-12-14T22:30:50+00:00December 14, 2023|340b, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|

MedPAC Meets, Makes 2025 Payment Recommendations

2025 Medicare payments led the agenda at last week’s meeting of the Medicare Payment Advisory Commission. After hearing presentations on the various Medicare payment systems and discussing the adequacy of current Medicare reimbursement, MedPAC’s commissioners provisionally endorses the following changes in 2025 Medicare payments. Inpatient and outpatient services – an update provided for in current law plus 1.5 percent and a shift to a safety-net index policy that would pay safety-net hospitals another $4 billion. Physicians and other health professionals – an increase of 50 percent of the Medicare economic index and introduction of an add-on payment for services provided [...]

joe2023-12-12T17:52:27+00:00December 13, 2023|hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|