Medicare

Federal Health Policy Update for April 27

The following is the latest health policy news from the federal government for April 21-27. Some of the language used below is taken directly from government documents. End of the COVID-19 Public Health Emergency DeBrunner & Associates has prepared a summary of the status of selected government health care waivers and flexibilities upon the expiration of the COVID-19 public health emergency on May 11. The DeBrunner summary covers telehealth, COVID-19 treatment and coverage, flexible hospital operations, long-term-care hospitals, inpatient rehabilitation facilities and units, patient cost-sharing, and state Medicaid waivers. Find the summary here. CMS has posted a new FAQ that [...]

iqtsupport2023-04-27T18:37:44-04:00April 27, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid long-term services and supports, Medicaid regulations, Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for April 20

The following is the latest health policy news from the federal government for April 8 – 20. Some of the language used below is taken directly from government documents. The White House The Biden administration has announced a plan to expand health coverage for Deferred Action for Childhood Arrivals (DACA) individuals. To this end, it announced that HHS will soon propose a rule amending the definition of “lawful presence,” for purposes of Medicaid and Affordable Care Act coverage, to include DACA recipients. If finalized, the rule would make DACA individuals eligible for these programs for the first time. Under the proposed rule, [...]

iqtsupport2023-04-20T17:24:28-04:00April 20, 2023|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

Federal Health Policy Update for April 7

The following is the latest health policy news from the federal government for March 31 – April 7. Some of the language used below is taken directly from government documents. The White House President Biden has signed an executive order calling for the modernization of the regulatory review process. Among other objectives, the order seeks to improve the effectiveness of the regulatory review process and promote inclusive regulatory policy and public participation. The order gives the Office of Management and Budget, through its Office of Information and Regulatory Affairs and in consultation with the Council of Economic Advisers and representatives [...]

iqtsupport2023-04-07T17:07:33-04:00April 7, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|

Federal Health Policy Update for March 30

The following is the latest health policy news from the federal government for March 24-30. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS’s Center for Medicare and Medicaid Innovation (CMMI) has extended its Medicare Advantage Value-Based Insurance Design (VBID) Model for calendar years 2025 through 2030 and will introduce changes intended to address more fully the health-related social needs of patients, advance health equity, and improve care for patients with serious illness. Learn more from this CMS announcement, which includes a link to additional information about the program. CMS [...]

iqtsupport2023-03-30T17:20:37-04:00March 30, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for March 23

The following is the latest health policy news from the federal government for March 17-23. Some of the language used below is taken directly from government documents. No Surprises Act After a February ruling in federal court that aspects of CMS’s implementation of the 2020 No Surprises Act contradicted the language of the act itself and unfairly favored payers over providers, CMS ordered a moratorium on new arbitration decisions for disputes filed on or after October 25, 2022 while it reviewed and revised its guidance on how payment disputes should be decided. Now, CMS has completed that task and issued [...]

iqtsupport2023-03-23T16:11:42-04:00March 23, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare|

MedPAC Offers FY 2024 Rate Recommendations

Medicare rates would rise for some providers and fall for others based on recommendations made to Congress last week by the Medicare Payment Advisory Commission, the independent congressional agency that advises Congress on Medicare reimbursement matters. MedPAC’s rate recommendations to Congress and the administration, which it approved at its January 2023 meeting, are: Outpatient and inpatient prospective payment systems – under current law, the estimated increase would be about 2.9 percent; MedPAC proposes 2.9 percent plus one percent. Physician services – increase fees 50 percent of the projected increase in the medical economic index (MEI). Skilled nursing facilities – reduce [...]

iqtsupport2023-03-22T06:00:32-04:00March 22, 2023|Congress, hospitals, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for March 16

The following is the latest health policy news from the federal government for March 13-16. Some of the language used below is taken directly from government documents. Medicare Payment Advisory Commission (MedPAC) MedPAC has published its “March 2023 Report to the Congress: Medicare Payment Policy.” In this year’s report MedPAC considers the context of the Medicare program, including the near-term consequences of COVID-19 and the longer-term effects of program spending on the federal budget and the program’s financial sustainability. It evaluates payment adequacy and make recommendations concerning Medicare payment policy in 2024 for selected fee-for-service payment systems but explains that [...]

iqtsupport2023-03-16T17:31:47-04:00March 16, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

MedPAC Meets

The government agency that advises Congress on Medicare payment matters met publicly in Washington, D.C. last week. During the virtual meeting, members of the Medicare Payment Advisory Commission discussed: reforming Medicare’s wage index system addressing the high prices of drugs covered under Medicare Part B a prototype design for a post-acute care prospective payment system favorable selection and future directions for Medicare Advantage payment policy aligning fee-for-service payment rates across ambulatory care settings MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are not binding on either Congress or the administration, MedPAC is [...]

iqtsupport2023-03-09T13:00:37-05:00March 9, 2023|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, post-acute care|

Administration to Propose Extending Medicare Solvency and Lowering Beneficiary Costs

Later this week the Biden administration will offer proposals that seek to extend the solvency of the Medicare Trust Fund and reduce beneficiaries’ health care costs. As part of the proposed FY 2024 federal budget the administration will present this week, it will call for extending the solvency of the Medicare Trust Fund by increasing the Medicare tax rate on income greater than $400,000 a year; closing loopholes in current Medicare taxes and depositing Medicare net investment income tax proceeds into the Medicare Trust Fund; and crediting savings from proposed prescription drug reforms to that same trust fund. To reduce [...]

iqtsupport2023-03-08T13:00:58-05:00March 8, 2023|Medicare|

Seven Apply for Rural Emergency Hospital Designation

With more than 140 rural hospitals closing since 2010 and more currently in financial trouble, a modest number of such facilities are hoping to avoid a similar fate by applying to the Centers for Medicare & Medicaid Services to become “rural emergency hospitals,” a new Medicare provider type created to preserve access to care in rural areas. Hospitals that become rural emergency hospitals will receive an annual fee of more than $3 million from Medicare and a five percent increase in their Medicare payments but must retain 24-hour emergency services while limiting their inpatient services to leave just enough time [...]

iqtsupport2023-03-08T06:00:26-05:00March 8, 2023|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare reimbursement policy|