MedPAC

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 [...]

admin2023-09-07T16:39:42+00:00September 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|

Federal Health Policy Update for August 31

The following is the latest health policy news from the federal government for August 25-31. Some of the language used below is taken directly from government documents. No Surprises Act For the second time in less than a month a court has rejected how federal agencies are implementing the Independent Dispute Resolution process of the No Surprises Act. A federal court concluded that the process for establishing the Qualifying Payment Amount, or QPA – the median rate insurers pay for in-network services and a critical factor in settling payment disputes – inappropriately permits insurers to depress that rate and unfairly [...]

admin2023-08-31T16:09:59+00:00August 31, 2023|Centers for Medicare & Medicaid Services, Medicaid, Medicare, MedPAC|

Federal Health Policy Update for August 24

The following is the latest health policy news from the federal government for August 11-24. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services After suspending the No Surprises Act-created Independent Dispute Resolution process in the wake of a court ruling striking down a recent increase in fees for that process, CMS has established a new rate structure for initiating the adjudication of payment disagreements between providers and payers. It explains the new rate structure in this new FAQ, which nevertheless notes that despite the creation of new rates, the Independent [...]

Federal Health Policy Update for August 10

The following is the latest health policy news from the federal government for August 4-10. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has temporarily suspended the federal Independent Dispute Resolution process, which adjudicates problems involving surprise medical bills, in the wake of a federal court ruling that found some of the process’s underlying regulations invalid. CMS has directed the certified Independent Dispute Resolution entities to pause all dispute resolution activities. As a result, providers and insurers temporarily cannot initiate new disputes. Learn more from this CMS notice. CMS [...]

admin2023-08-10T16:32:27+00:00August 10, 2023|Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|

MedPAC Urges Congress to Embrace Site-Neutral Medicare Outpatient Payments

Medicare should pay for outpatient care on a site-neutral basis, MedPAC has told Congress in its annual recommendations. Proponents of such a change – including the Medicare Payment Advisory Commission – argue that Medicare should not pay more for services than it needs to and can, if it believes hospital-associated facilities deserve more money, find better ways to provide such additional resources. They also believe such a policy encourages the acquisition of independent medical practices by operators that then increase the price of the same services and that site-neutral payments would help preserve such independent practices while also driving down [...]

admin2023-06-26T06:00:56+00:00June 26, 2023|Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for June 22

The following is the latest health policy news from the federal government for June 9-22. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced new flexibilities to help keep Americans insured as states resume Medicaid and Children’s Health Insurance Program (CHIP) renewals. The new flexibilities were announced in a letter sent by HHS Secretary Xavier Becerra to the nation’s governors urging them to adopt all available flexibilities to minimize avoidable coverage losses among children and families. The new flexibilities include permitting managed care plans to assist people currently [...]

admin2023-06-22T16:04:30+00:00June 22, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, Telehealth|

Health Policy Update for June 8

The following is the latest health policy news from the federal government for May 28 – June 8. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced a new primary care model – the Making Care Primary Model – that will be tested by the Center for Medicare and Medicaid Innovation in eight states. The model seeks to improve care for patients by expanding and enhancing care management and care coordination, equipping primary care clinicians with tools to form partnerships with health care specialists, and leveraging community-based connections [...]

admin2023-06-08T16:41:06+00:00June 8, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for April 27

The following is the latest health policy news from the federal government for April 21-27. Some of the language used below is taken directly from government documents. End of the COVID-19 Public Health Emergency DeBrunner & Associates has prepared a summary of the status of selected government health care waivers and flexibilities upon the expiration of the COVID-19 public health emergency on May 11. The DeBrunner summary covers telehealth, COVID-19 treatment and coverage, flexible hospital operations, long-term-care hospitals, inpatient rehabilitation facilities and units, patient cost-sharing, and state Medicaid waivers. Find the summary here. CMS has posted a new FAQ that [...]

admin2023-04-27T18:37:44+00:00April 27, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid long-term services and supports, Medicaid regulations, Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for April 20

The following is the latest health policy news from the federal government for April 8 – 20. Some of the language used below is taken directly from government documents. The White House The Biden administration has announced a plan to expand health coverage for Deferred Action for Childhood Arrivals (DACA) individuals. To this end, it announced that HHS will soon propose a rule amending the definition of “lawful presence,” for purposes of Medicaid and Affordable Care Act coverage, to include DACA recipients. If finalized, the rule would make DACA individuals eligible for these programs for the first time. Under the proposed rule, [...]

admin2023-04-20T17:24:28+00:00April 20, 2023|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

Federal Health Policy Update for April 7

The following is the latest health policy news from the federal government for March 31 – April 7. Some of the language used below is taken directly from government documents. The White House President Biden has signed an executive order calling for the modernization of the regulatory review process. Among other objectives, the order seeks to improve the effectiveness of the regulatory review process and promote inclusive regulatory policy and public participation. The order gives the Office of Management and Budget, through its Office of Information and Regulatory Affairs and in consultation with the Council of Economic Advisers and representatives [...]

admin2023-04-07T17:07:33+00:00April 7, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|