Medicare

Federal Health Policy Update for January 5

The following is the latest health policy news from the federal government for December 23 through January 5. Some of the language used below is taken directly from government documents. No Surprises Act HHS, the Department of Labor, and the Department of the Treasury have announced increases in the administrative fee for initiating the No Surprises Act’s Independent Dispute Resolution (IDR) process and for certified IDR entities. Learn more about the administrative fee change here and about the certified IDR entity fee change here. Both changes took effect on January 1. HHS, the Department of Labor, and the Department of the [...]

iqtsupport2023-01-05T17:15:07-05:00January 5, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for December 22

The following is the latest health policy news from the federal government for the week of December 19-22. Some of the language used below is taken directly from government documents. Congress As of this writing, Congress continues to work on an FY 2023 omnibus spending bill: the Senate has passed it but the House has not yet addressed it. Highlights of what negotiators have agreed to – but that have not yet been adopted – include: Preventing the additional four percent Medicare sequester for two years. Reducing by more than half the 4.5 percent cut in Medicare payments to physicians [...]

iqtsupport2022-12-22T17:30:38-05:00December 22, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, hospitals, Medicaid, Medicare, Medicare bad debt reimbursement, Medicare regulations, Medicare reimbursement policy, Telehealth|

Paxlovid Will Soon Cost Patients

Free Paxlovid treatment for COVID-19 will soon be a thing of the past for many people because in the coming months the federal government plans to stop paying for the drug for everyone who needs it. Nearly six million Americans so far have taken Paxlovid after being diagnosed with COVID, but by the middle of 2023 the federal government is expected to stop footing the bill. Currently, it pays $530 a dose – a discounted price. When that happens the drug may become far less accessible. Because Paxlovid is only authorized under federal emergency use authorization, Medicare drug plans are [...]

iqtsupport2022-12-16T06:00:16-05:00December 16, 2022|COVID-19, Medicaid, Medicare|

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15. Some of the language used below is taken directly from government documents. White House The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans. Learn more about the plan from this White House fact sheet and go here for a transcript of the White House [...]

MedPAC Considers 2023 Medicare Rates at December Meeting

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 and debated: Assessing payment adequacy and updating payments: hospital inpatient and outpatient services and supporting Medicare safety-net hospitals – commissioners discussed a proposal to increase FY 2024 rates one percentage point more than current law prescribes. Commissioners also discussed additional steps they might take to provide better support to safety-net hospitals, which they described as “…hospitals with high shares of low-income Medicare patients.” Status report: ambulatory surgical center services. Assessing payment [...]

iqtsupport2022-12-14T06:00:43-05:00December 14, 2022|Congress, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

CBO Looks For Cost-Cutting Opportunities

The Congressional Budget Office periodically issues a compendium of policy options for changing federal tax and spending policies in particular areas and reducing federal spending. For each option the CBO presents an estimate of its effect on the budget without making recommendations either in favor of or against those options. The latest update of options includes a number with potential implications for health care providers, including: changing the cost-sharing rules for Medicare and restricting medigap insurance reducing Medicare Advantage benchmarks reducing Medicare’s coverage of bad debt consolidating and reducing federal payments for graduate medical education at teaching hospitals establishing caps [...]

iqtsupport2022-12-13T06:00:58-05:00December 13, 2022|deficit reduction, hospitals, Medicaid, Medicare, Medicare bad debt reimbursement|

Federal Health Policy Update for December 8

The following is the latest health policy news from the federal government for the week of December 4-8. Some of the language used below is taken directly from government documents. No Surprises Act CMS has published an FAQ about implementation of good faith estimates for uninsured and self-pay patients under the No Surprises Act. In the FAQ the agency explains that it will extend enforcement discretion for situations in which good faith estimates do not include expected charges from co-providers or co-facilities. This enforcement discretion was expected to end on January 1 but CMS now writes that it will remain [...]

iqtsupport2022-12-08T17:09:11-05:00December 8, 2022|Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid regulations, Medicare, Medicare bad debt reimbursement, Medicare cuts, Medicare regulations, Medicare reimbursement policy, Telehealth|

FEDERAL HEALTH POLICY UPDATE FOR December 1

The following is the latest health policy news from the federal government for the week of November 28 to December 1. Some of the language used below is taken directly from government documents. 340B HHS and its Health Resources and Services Administration (HRSA) have proposed revising the current 340B administrative dispute resolution process. Since the current process was introduced in 2020 HRSA has encountered policy and operational challenges with its implementation and now proposes revising it and is soliciting comment on its proposed new approach. Changes include changing the nature of the dispute resolution process, using different kinds of professionals [...]

Federal Health Policy Update for November 17

The following is the latest health policy news from the federal government for the week of November 11 to 17. Some of the language used below is taken directly from government documents. Provider Relief Fund Providers that cited extenuating circumstances for failing to submit Provider Relief Fund financial reports on time for reporting period 3 and were approved to submit their reports late must submit those late reports by December 2. Learn more here. Centers for Medicare & Medicaid Services CMS has posted three downloadable sample formats that hospitals can use to meet federal requirements for posting in a machine-readable [...]

iqtsupport2022-11-17T17:29:00-05:00November 17, 2022|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Medicaid, Medicare, Telehealth|

117th Congress’s Waning Hours

In addition to its biggest challenge – funding the federal government, authorization for which ends on December 16 – Congress has a number of health care issues on its agenda that at least some lawmakers and health care industry stakeholders would like to see it address before the year ends. Those issues include the cut in Medicare payments to physicians scheduled to take place on January 1; the desire of many to make permanent some of the flexibilities to use telehealth that were temporarily authorized in response to the COVID-19 public health emergency; additional pandemic funding for new vaccines, new [...]

iqtsupport2022-11-17T06:00:49-05:00November 17, 2022|Congress, COVID-19, Medicare, Medicare reimbursement policy, Telehealth|