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 [...]

iqtsupport2023-11-13T06:00:34-05:00November 13, 2023|Medicare, Medicare post-acute care, Medicare reimbursement policy, post-acute care|

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 [...]

iqtsupport2023-11-09T15:41:22-05:00November 9, 2023|340b, Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

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 [...]

iqtsupport2023-11-02T18:01:15-04:00November 2, 2023|340b, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare reimbursement policy|

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 [...]

iqtsupport2023-11-02T06:00:32-04:00November 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 [...]

iqtsupport2023-11-01T13:00:57-04:00November 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 [...]

iqtsupport2023-10-26T15:51:16-04:00October 26, 2023|340b, Centers for Medicare & Medicaid Services, Congress, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare reimbursement policy, MedPAC|

“Rural Emergency Hospital” Status: To Be or Not to Be?

That is the question for many of the country’s small rural hospitals, including the more than 600 that are thought to be in danger of closing in the near future. In 2020 Congress directed the Centers for Medicare & Medicaid Services to introduce the Rural Emergency Hospital, a new Medicare provider type that would give additional federal funding to qualified rural hospitals in exchange for changes in how they do business. For small hospitals that are willing to discontinue providing inpatient services and cease participating in the 340B prescription drug discount program, CMS offers enhanced payments for outpatient services and [...]

iqtsupport2023-10-25T01:00:35-04:00October 25, 2023|hospitals, Medicare, Medicare reimbursement policy|

MedPAC Outlines Plans for the Coming Year

The Medicare Payment Advisory Commission has shared its agenda for its 2023-2024 public meeting cycle. According to MedPAC, it will engage in its regular work of offering recommendations to Congress on the adequacy of Medicare payments to providers and, as needed, suggest changes in those payments. In addition, it will fulfill two statutory requirements in the coming year: to evaluate Medicare Advantage special needs plans for individuals eligible for both Medicare and Medicaid and to review the new “Rural Emergency Hospital” designation. In addition, MedPAC writes that We are working on several other issues in the Medicare program as well, [...]

iqtsupport2023-10-24T16:43:49-04:00October 24, 2023|Centers for Medicare & Medicaid Services, Congress, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for October 19

The following is the latest health policy news from the federal government for October 13-19. Some of the language used below is taken directly from government documents. Congress At this moment there is still no Speaker of the House of Representatives. After 20 and then 22 House Republicans voted against Rep. Jim Jordan (R-Ohio) on Tuesday and Wednesday this week, Mr. Jordan has joined others, including senior Democrats, in supporting a plan to expand the powers of the temporary speaker, Rep. Patrick McHenry (R-NC). Mr. Jordan remains the speaker designee, an option that will enable him to continue to seek [...]

iqtsupport2023-10-19T15:01:13-04:00October 19, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare post-acute care, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for October 12

The following is the latest health policy news from the federal government for October 6-12. Some of the language used below is taken directly from government documents. No Surprises Act CMS has reopened the federal independent dispute resolution (IDR) portal for the initiation ofnew single disputes, including single disputes involving bundled payment arrangements, but parties still cannot initiate new disputes involving air ambulance services and batched disputes for air ambulance and non-air ambulance items and services. IDR portal functionalities related to previously initiated batched disputes also are unavailable. Learn more about this action from this CMS announcement, which includes an [...]

iqtsupport2023-10-12T14:42:15-04:00October 12, 2023|COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, social determinants of health, Telehealth|