Medicare

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|

Federal Health Policy Update for November 10

The following is the latest health policy news from the federal government for the week of November 7 to 10. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published a notice advising teaching hospitals that they have until November 18 to ask Medicare to reconsider their per resident amounts or resident caps as shown in the Hospital Cost Report Information System (HCRIS) associated with cost reports that, as of July 1, 2022, were not reopenable. Learn more from this CMS notice. Due to an unplanned system outage of [...]

iqtsupport2022-11-10T16:23:21-05:00November 10, 2022|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, 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 and debated: differences in quality measure results across Medicare populations policy options for increasing Medicare payments to primary care clinicians aligning fee-for-service payment rates across ambulatory settings mandated report: evaluation of a prototype design for a post-acute care prospective payment system supporting Medicare safety-net hospitals MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are not binding on Congress or the administration, MedPAC is [...]

iqtsupport2022-11-08T06:00:13-05:00November 8, 2022|hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

FEDERAL HEALTH POLICY UPDATE FOR November 3

The following is the latest health policy news from the federal government for the week of October 31 to November 3. Some of the language used below is taken directly from government documents. Medicare Payment Regulations In the past week CMS has published four regulations presenting how it will pay providers in the coming year. Outpatient prospective payment system – CMS announced a 3.8 percent increase for Medicare outpatient and ambulatory surgical payments. It also adopted its proposal to establish rural emergency hospitals as a new kind of hospital provider; removed 11 surgical procedures from its inpatient-only list and authorized [...]

iqtsupport2022-11-03T17:41:10-04:00November 3, 2022|340b, Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for October 27

The following is the latest health policy news from the federal government for the week of October 21 to October 27. Some of the language used below is taken directly from government documents. 340B Responding to a federal court ruling that the federal government has shortchanged hospitals in its payments for 340B-covered prescription drugs, CMS has announced how it will compensate hospitals for its underpayments – at least for the 2023 fiscal year. According to CMS, it “…will apply the default rate (generally ASP plus 6%) to 340B-acquired drugs for the rest of the year. CMS also will reprocess claims [...]

iqtsupport2022-10-27T17:06:24-04:00October 27, 2022|340b, Center for Medicare and Medicaid Innovation, CMMI, COVID-19, Medicaid, Medicaid regulations for long-term care, Medicare, Medicare reimbursement policy, MedPAC, post-acute care|

FEDERAL HEALTH POLICY UPDATE FOR OCTOBER 20

The following is the latest health policy news from the federal government for the week of October 14 to October 20. Some of the language used below is taken directly from government documents. White House President Biden has signed an executive order on lowering prescription drug costs. The order directs HHS to consider additional actions to further drive down prescription drug costs, encourages it to pursue such actions through its Center for Medicare and Medicaid Innovation (CMMI), and directs HHS to submit a formal report within 90 days outlining any plans to use CMMI’s authority to lower drug costs and [...]

iqtsupport2022-10-20T17:01:23-04:00October 20, 2022|Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid and housing, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

FEDERAL HEALTH POLICY UPDATE FOR OCTOBER 13

The following is the latest health policy news from the federal government for the week of October 7 to October 13. Some of the language used below is taken directly from government documents. Public Health Emergency Declaration HHS Secretary Becerra has renewed the COVID-19 Public Health Emergency declaration. This renewal does not provide the promised 60-day notice of the PHE’s end, so for now, the current declaration is set expire on January 11, 2023. We will continue to update you on any changes to the PHE timeline. You can view the PHE renewal here. White House The White House COVID-19 [...]

iqtsupport2022-10-13T17:14:18-04:00October 13, 2022|Centers for Medicare & Medicaid Services, COVID-19, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|