Medicare

“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|

MedPAC Meets

The members of the Medicare Payment Advisory Commission held their latest public meeting last week. The issues addressed during the meeting were: Current legal updates to Medicare’s payment rates for clinician services. Staffing ratios and turnover rates in nursing facilities. An alternative method to establish Medicare payments for selected conditions treated in inpatient rehabilitation facilities. A staff work plan for examining prices of generic drugs under Part D For an overview of each of these issues and links to the presentations made by MedPAC’s staff during the discussions, go here.

iqtsupport2023-10-12T13:00:04-04:00October 12, 2023|Centers for Medicare & Medicaid Services, Medicare, Medicare reimbursement policy, MedPAC, post-acute care|

Federal Health Policy Update for October 5

The following is the latest health policy news from the federal government for September 29 to October 5. Some of the language used below is taken directly from government documents. Congress Last Saturday, Congress passed a 45-day continuing resolution (CR) to fund the federal government through November 17. Part of that limited CR includes a delay of the scheduled $8 billion cut to Medicaid DSH allotments to states through the end of the CR. The bill also extends funding for community health centers and the National Health Services Corps for the same length of time. Congress will have to act [...]

iqtsupport2023-10-05T14:53:32-04:00October 5, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for September 28

The following is the latest health policy news from the federal government for September 22-28. Some of the language used below is taken directly from government documents. The White House President Biden has signed H.R. 2544, the Securing the U.S. Organ Procurement and Transplantation Network Act, which provides for awarding multiple grants, contracts, or cooperative agreements to operate the Organ Procurement and Transplantation Network. Congress Congressional leaders have not come to agreement on how to avert a federal government shutdown this weekend. While Senate leaders introduced a continuing resolution that would fund the government through November 17, that bill has [...]

iqtsupport2023-09-28T16:38:25-04:00September 28, 2023|Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Telehealth|

Federal Health Policy Update for September 21

The following is the latest health policy news from the federal government for September 15 - 21. Some of the language used below is taken directly from government documents. Congress With only nine days left in the current federal fiscal year, Congress still has not agreed on any kind of spending bill to keep the federal government operating past September 30. If the federal government shuts down, the Department of Health and Human Services (HHS) will “use the full extent of the authority under the Antideficiency Act (ADA) to maintain existing HHS activities…” In previous shutdowns, Medicare has continued to [...]

iqtsupport2023-09-21T15:37:11-04:00September 21, 2023|Alternative payment models, Congress, COVID-19, Medicaid, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for September 14

The following is the latest health policy news from the federal government for September 8-14. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has posted a guide providing details about how it calculates scores for its Merit-Based Incentive Payment System in the 2023 performance year. Find the guide by going here, scrolling down to “Full Resource Library,” and clicking “2023 Traditional MIPS Scoring Guide” for a direct download of the guide. CMS has posted a notice about a data breach at a CMS contractor, Maximus Federal Services, Inc. (Maximus), [...]

iqtsupport2023-09-14T16:59:54-04:00September 14, 2023|Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicare|

Federal Health Policy Update for September 7

The following is the latest health policy news from the federal government for September 1-7. Some of the language used below is taken directly from government documents. Congress House Republicans plan to introduce the Lower Cost, More Transparency Act for consideration before the end of the year. This bill includes provisions passed by three committees with health care jurisdiction: House Ways & Means, Energy & Commerce, and Education & Workforce. Some of the bill’s provisions would: eliminate scheduled Medicaid DSH cuts for FY 2024 and FY 2025; reauthorize and extend funding for the Community Health Center program, the National Health [...]

iqtsupport2023-09-07T16:39:42-04:00September 7, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|