Medicare reimbursement policy

Federal Health Policy Update for June 20

The following is the latest health policy news from the federal government for June 14-20. Some of the language used below is taken directly from government documents. No Surprises Act HHS and the departments of Labor and the Treasury have announced a policy that offers extra time to health care providers whose desire to engage in No Surprises Act adjudication of payment disagreements with payers was affected by the Change Healthcare cybersecurity attack. Under this temporary policy, providers, facilities, and providers of air ambulance services whose ability to initiate timely No Surprises Act open negotiation for any item or service [...]

joe2024-06-20T19:22:28-04:00June 20, 2024|340b, Alternative payment models, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for June 13

The following is the latest health policy news from the federal government for June 7-13. Some of the language used below is taken directly from government document. Supreme Court The Supreme Court has agreed to hear a challenge to how the Department of Health and Human Services calculates hospitals’ Medicare disproportionate share (Medicare DSH) payments. The case was added to the court’s 2024-2025 schedule. Congress Individual members and key committees in Congress continue to introduce and mark up health care-related legislation with an eye toward including these initiatives in an end-of-year package. This work is expected to continue through the [...]

joe2024-06-13T20:15:06-04:00June 13, 2024|Alternative payment models, Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for June 6

The following is the latest health policy news from the federal government for May 31-June 6. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services The deadline for stakeholders to submit comments on CMS’s proposed FY 2025 Medicare inpatient prospective payment system and long-term-care hospital prospective payment system regulation is Monday, June 10. Go here for further information about the proposed rule and how to submit comments. CMS has posted a bulletin describing billing changes in the Medicare hospital outpatient prospective payment system that will take effect on July 1. Find [...]

joe2024-06-06T20:37:05-04:00June 6, 2024|Accountable Care Organization, ACO, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for May 30

The following is the latest health policy news from the federal government for May 24-30. Some of the language used below is taken directly from government documents. Congress When the House and Senate return to Washington, DC from the Memorial Day recess next week committees will resume holding hearings and markups on health care policy while appropriators will focus on funding for federal fiscal year 2025, which begins October 1. While there seems to be plenty of activity in Congress it is widely expected that only the most essential bills, like emergency supplemental packages and bills to keep the federal [...]

joe2024-05-30T21:29:22-04:00May 30, 2024|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, hospitals, Medicaid, Medicaid managed care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for May 23

The following is the latest health policy news from the federal government for May 18-23. Some of the language used below is taken directly from government documents. Congress Leaders of the Senate Finance Committee have released a white paper outlining potential reforms of how Medicare pays physicians and how Medicare might better meet the needs of those with chronic illnesses. The white paper notes areas of interest the committee sees as opportunities for reform, including: Creating sustainable payment updates to ensure clinicians can own and operate their practices. Creating incentives for alternative payment models that reward providing better care at [...]

joe2024-05-23T18:28:33-04:00May 23, 2024|340b, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for May 17

The following is the latest health policy news from the federal government for May 10-17. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced a further extension of deadlines for fulfilling certain Medicaid unwinding requirements. Some current deadlines will be extended to December 31, 2024 and others through June 30, 2025. States also may seek to extend selected COVID-19-related flexibilities through June 30, 2025. Among the deadlines affected by this announcement are those for using ex parte information to determine eligibility; permitting Medicaid managed care organizations to help [...]

joe2024-05-17T20:18:34-04:00May 17, 2024|Centers for Medicare & Medicaid Services, health equity, hospitals, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, social determinants of health|

Federal Health Policy Update for May 2

The following is the latest health policy news from the federal government for April 26 – May 2. Some of the language used below is taken directly from government documents. No Surprises Act – Independent Dispute Resolution Process CMS has announced a new process for resubmitting Independent Dispute Resolution (IDR) disputes that were originally improperly batched or bundled.This new resubmission process is automated in the federal IDR portal and seeks to streamline federal IDR operations. For further information about this new process and an implementation timetable, see this CMS announcement. CMS also has posted a user guide for the IDR [...]

joe2024-05-02T19:49:55-04:00May 2, 2024|Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

MedPAC Meets

Members of the Medicare Payment Advisory Commission met publicly last week in Washington, D.C. Their agenda consisted of the following issues: telehealth in Medicare alternative approaches to lowering Medicare payments for selected conditions in inpatient rehabilitation facilities considering approaches for updating the Medicare physician fee schedule assessing consistency between plan-submitted data sources for Medicare Advantage enrollees generic drug pricing under Part D initial findings from analysis of Medicare Part B payment rates and 340B ceiling prices Go here for a brief overview of each agenda item and links to the staff presentations on those issues. MedPAC is an independent congressional [...]

joe2024-04-16T15:35:18-04:00April 16, 2024|340b, Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for April 12

The following is the latest health policy news from the federal government for April 5-11. Some of the language used below is taken directly from government documents. CMS – Proposed FY 2025 Medicare Inpatient Prospective Payment System Regulation Earlier this week CMS issued its proposed FY 2025 Medicare inpatient prospective payment system regulation – the rule under which it envisions paying acute-care hospitals, critical access hospitals, and long-term care hospitals for inpatient care in the coming fiscal year. Highlights of the proposed rule include: Rate increases of 2.6 percent for acute-care and critical access hospitals and 2.8 percent for LTCHs. [...]

MedPAC to Talk Telemedicine, Doc Payments, 340B, More

Members of the Medicare Payment Advisory Commission will meet publicly on Thursday, April 11 and Friday, April 12. Medicare reimbursement subjects on the two-day session’s agenda include: telehealth inpatient rehabilitation hospital payments the physician fee schedule Medicare Advantage Part D generic drug pricing Part B rate and 340B ceilings Go here for a more detailed look at the MedPAC agenda and for information about how to participate in the meeting.

joe2024-04-09T17:14:42-04:00April 9, 2024|340b, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, Telehealth|