Medicare

Federal Health Policy Update for November 30

The following is the latest health policy news from the federal government for November 17-30.  Some of the language used below is taken directly from government documents. No Surprises Act CMS has released two new FAQs to provide guidance in advance of the Independent Dispute Resolution portal reopening for batched disputes and air ambulance disputes; that service remains temporarily suspended.  These FAQs together explain how certified IDR entities may determine whether a dispute is appropriately batched in light of recent court rulings; provide information about policy for extending existing IDR deadlines once the federal IDR portal reopens to all batched [...]

Federal Health Policy Update for November 16

The following is the latest health policy news from the federal government for November 10-16.  Some of the language used below is taken directly from government documents. Congress This week Congress passed another continuing resolution (CR) to fund the federal government beyond Friday, when the current CR expires.  This bill establishes two separate deadlines for lawmakers to pass certain spending bills so they can avoid an omnibus bill that includes all 12 appropriations bills.  Congress must pass four of the spending bills by January 19 and the other bills by February 2.  The Labor, HHS, and Education bill, one of [...]

“Hospital at Home” Appears to be Working Well

The federal Acute Hospital Care at Home program introduced during the COVID-19 crisis appears to be working well, according to a new study. The program, intended to free hospital beds at the height of the COVID pandemic while protecting non-COVID patients from exposure to the virus, enabled hospitals meeting certain Centers for Medicare & Medicaid Services criteria to care for Medicare fee-for-service and non-managed care Medicaid patients in the home.  Participating patients were chosen according to CMS-approved safety criteria built around an assessment of the acuity of their medical conditions and whether they might reasonably be treated at home. An [...]

2023-11-15T06:00:50-05:00November 15, 2023|hospitals, Medicare|

MedPAC Meets

The commissioners of the Medicare Payment Advisory Commission recently met virtually.  The subjects on the agenda of their two-day meeting were: rural emergency hospitals dual-eligible special needs plans MedPAC’s work plan for hospice issues Medicare coverage of and payment for software as a medical service favorable selection in Medicare Advantage network management and prior authorization and their impact on access in Medicare Advantage 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 highly influential in governing circles and its recommendations often find [...]

Federal Health Policy Update for November 9

The following is the latest health policy news from the federal government for November 3-9.  Some of the language used below is taken directly from government documents. Congress Senate Finance Committee Earlier this week the Senate Finance Committee passed the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023.  The bill, which passed out of the committee by a vote of 26-0, would: eliminate $16 billion in cuts to Medicaid DSH for 2024 and 2025; soften the 2024 cut to Medicare physician payments by reducing the conversion factor by 2.15 percent rather than the 3.4 percent that CMS [...]

Federal Health Policy Update for November 2

The following is the latest health policy news from the federal government for October 27 – November 2.  Some of the language used below is taken directly from government documents. 340B Remedy Payments Late Thursday afternoon CMS published its final Medicare remedy for underpayments for 340B prescription drugs that was implemented in 2018 but rejected by the Supreme Court last year.  According to the regulation, 340B remedy payments to hospitals will be made after this rule takes effect, which is 60 days after it is officially published in the Federal Register; publication is scheduled for November 16. The final regulation [...]

Medicare Leaving Gaps in Care

Medicare is leaving large numbers of the program’s beneficiaries without at least some of the care they need. According to the Commonwealth Fund’s annual health care affordability survey, One-third of Medicare beneficiaries said it was difficult to afford health care costs, including more than half of beneficiaries under age 65. More than one in five beneficiaries reported delaying or skipping needed health care because of the cost, including more than four in 10 under age 65. More than one in five beneficiaries said health care costs made it harder for them to afford food and utility bills, including more than [...]

2023-11-02T06:00:32-04:00November 2, 2023|Medicare|

Telehealth Serving Some Medicare Patients Well

Medicare patients with serious mental health problems were well-served through telehealth during the COVID-19 crisis. According to a new study published by the JAMA Network, such patients experienced … 13.0% more mental health visits than those receiving care at practices that largely used in-person visits.  There were no changes in medication adherence, hospital and emergency department use, or mortality based on the extent of telemental health use. The study’s findings support continued use of telehealth for Medicare patients with mental health problems even now that the greatest threat of the pandemic has passed. Learn more about how the study was [...]

2023-11-01T13:00:57-04:00November 1, 2023|Medicare, Telehealth|

Federal Health Policy Update for October 26

The following is the latest health policy news from the federal government for October 20-26.  Some of the language used below is taken directly from government documents. Congress More than three weeks after House Republicans voted Rep. Kevin McCarthy (CA) out of the speaker’s office, the House has elected Rep. Mike Johnson (LA) to the position.  Speaker Johnson is a social conservative and has pushed for cuts to Medicare and Medicaid, including plans to roll back Medicaid expansion in 2019. The Speaker has said he intends for the House to take up as many FY 2024 spending bills as possible [...]

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