Medicare

Federal Health Policy Update for Wednesday, April 14

The following is the latest health policy news from the federal government as of 2:45 p.m. on Wednesday, April 14. Temporary Halt to Use of the Johnson & Johnson Janssen Vaccine The White House held a press briefing on Tuesday, April 13 during which the White House press secretary, its COVID-19 response coordinator, and Dr. Anthony Fauci discussed the decision to halt administration of the Johnson & Johnson (Janssen) vaccine until its safety can be further examined. Learn more from a transcript of that briefing. Representatives of the FDA and CDC briefed the news media on the situation involving the [...]

iqtsupport2021-04-14T17:11:09-04:00April 14, 2021|Coronavirus, COVID-19, Medicaid, Medicare|

Study of Cardiac Telehealth Yields Interesting Results

Increased use of telehealth among cardiac patients as a result of the COVID-19 pandemic has produced some interesting results. According to a study published by JAMA Open Network, …[cardiology] patients using COVID-era remote visits were more likely to be Asian, Black, or Hispanic individuals, have private insurance, and have cardiovascular comorbidities. Compared with pre-COVID in-person visits, clinicians during COVID-era video and telephone visits had a significantly lower odds of ordering any medication as well as most tests. The use of telehealth has increased significantly since the start of the COVID-19 pandemic and the introduction of temporary Medicare regulations that encourage [...]

iqtsupport2021-04-12T06:00:02-04:00April 12, 2021|Medicare, Telehealth|

MedPAC: Go Slow on Expanding Medicare Telehealth

MedPAC wants Medicare to test the impact of telehealth on health care under non-COVID-19 conditions before moving forward with expanding the tool’s use in the Medicare population. In a news release accompanying its recently released annual report to Congress on Medicare payment policy, the Medicare Payment Advisory Commission writes that In the report, we present a policy option for expanded coverage for Medicare telehealth policy after the PHE is over. Under the policy option, policymakers should temporarily continue some of the telehealth expansions for a limited duration of time (e.g., one to two years after the PHE) to gather more [...]

iqtsupport2021-03-19T13:00:08-04:00March 19, 2021|Medicare, Medicare reimbursement policy, Telehealth|

MedPAC Offers 2022 Rate Recommendations

MedPAC has recommended modest pay increases for some health care providers and no increases for others in its annual report on Medicare payment policy to Congress. In the report, the Medicare Payment Advisory Commission recommends the following changes in Medicare rates for 2022: 2% increase for Medicare inpatient and outpatient services 2% increase for long-term-care hospitals no increase for doctors and other medical professionals no increases for ambulatory surgical centers, outpatient dialysis facilities, skilled nursing facilities, and hospices 5% reductions for home health agencies and inpatient rehabilitation facilities While MedPAC’s recommendations to Congress are not binding on the administration, its [...]

iqtsupport2021-03-18T13:00:08-04:00March 18, 2021|Medicare, Medicare reimbursement policy, MedPAC|

House to Consider Extending Medicare Sequester Delay

The moratorium on the two percent sequestration of Medicare payments could be extended under a bill the House may consider this week. If adopted, the bill would extend the sequester delay for nine months, providing financial relief that many health care providers seek as they continue to deal with the financial challenges posed by COVID-19. The sequester delay was implemented early in the pandemic as a means of providing additional Medicare revenue to hospitals and other health care providers at a time when many people were delaying seeking medical attention out of fear of contracting COVID-19. Without action by Congress, [...]

iqtsupport2021-03-18T06:00:49-04:00March 18, 2021|Medicare, Medicare cuts, Medicare reimbursement policy|

MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week to discuss various Medicare payment issues. Among the issues discussed at MedPAC’s March meeting were: Medicare beneficiary access to care in rural areas skilled nursing facility value-based purchasing program and proposed replacement streamlining CMS’s portfolio of alternative payment models balancing efficiency with equity in Medicare Advantage benchmark policy relationship between clinician services and other Medicare services revising Medicare’s indirect medical education payments to better reflect teaching hospitals’ costs Medicare’s vaccine coverage and payment separately payable drugs in the hospital outpatient prospective payment system MedPAC is an independent congressional agency [...]

iqtsupport2021-03-10T06:00:08-05:00March 10, 2021|Medicare, MedPAC|

Analysts Look at Medicare Wage System

The Congressional Research Service has published a new report on the Medicare hospital wage index system. The agency undertook its analysis because Some Members of Congress, hospitals, and independent analysts have expressed interest in the differences in Medicare hospital payments by geographic area, based on the wage index. Some of these stakeholders have recommended changes to the wage index to more accurately reflect labor market forces faced by hospitals. Although some modifications to the wage index have been implemented, there is no consensus about systematic reforms. In the report the CRS describes how the geographic wage system works and what [...]

iqtsupport2021-03-09T06:00:24-05:00March 9, 2021|Medicare, Medicare reimbursement policy|

Medicare Pays Far More Than Medicaid for Brand-Name Drugs

Medicare pays three times as much for brand-name drugs at retail pharmacies as Medicaid and two-and-a-half times more for specialty drugs, according to a new analysis by the Congressional Budget Office. The vast difference occurs because of how drug prices are established for the two programs. Under Medicare Part D, individual payers and manufacturers negotiate prices based on commercial market conditions while for Medicaid, federal law requires manufacturers to provide rebates. Learn more about the differences between Medicare and Medicaid prescription drug prices, how and why those differences occur, and their implications in the CBO report “A Comparison of Brand-Name [...]

iqtsupport2021-02-26T06:00:54-05:00February 26, 2021|Medicaid, Medicare|

Congress Approves New GME Slots

The year-end federal COVID-19 relief bill brought changes to Medicare’s graduate medical education program. Among those changes: 200 new GME slots over the next five years additional federal funding for residency training – the first new funding for the program in nearly a quarter of a century new opportunities for some hospitals to establish new (and higher) resident caps new flexibilities for rural hospitals to participate in physician training programs Learn more in the National Law Review article “COVID-19: Reimbursement Corner: Graduate Medical Education Gets Major Boost From Congressional Appropriations Bill.”

iqtsupport2021-01-06T06:00:33-05:00January 6, 2021|Medicare|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. MedPAC’s proposed Medicare 2021 payment recommendations dominated the December agenda, including: hospital inpatient and outpatient payments ambulatory surgical center payments physician and health professional payments hospice payments home health care payments inpatient rehabilitation facility payments long-term care hospital payments In addition, MedPAC discussed Medicare’s policy for transfers between post-acute-care facilities and hospice and received a staff update on the Medicare Advantage program. MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are not binding [...]

iqtsupport2020-12-10T06:00:36-05:00December 10, 2020|Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|