Policy Updates

Federal Health Policy Update for March 27

The following is the latest health policy news from the federal government for March 21-27. Some of the language used below is taken directly from government documents. Congress The House and Senate need to pass a joint budget resolution as a first step before committees can begin writing legislation to pass under reconciliation. Each chamber has passed its own budget resolution and while the two are very different, congressional leaders have agreed to write a less prescriptive resolution that will permit each chamber’s committees to determine the level of spending and saving required and then will try to work out [...]

joe2025-03-27T17:03:07-04:00March 27, 2025|Centers for Medicare & Medicaid Services, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Five Million Could Lose Medicaid With Federal Work Requirement

If adopted, a federal requirement that Medicaid beneficiaries in expansion states work at least 80 hours a month to retain their eligibility for Medicaid could result in five million people losing their Medicaid coverage, according to a new analysis. And if that requirement were to be expanded to all Medicaid beneficiaries, that number could rise to as many as 30 million people. The analysis, included in a report released by the Robert Wood Johnson Foundation and the Urban Institute, concluded that: Between 4.6 and 5.2 million adults living in states that expanded Medicaid would lose Medicaid coverage next year under [...]

joe2025-03-26T09:46:47-04:00March 26, 2025|Medicaid|

MedPAC Makes 2026 Medicare Rate Recommendations

The Medicare Payment Advisory Commission recently released “Report to the Congress: Medicare Payment Policy,” its required March report to Congress. In addition to addressing a variety of Medicare issues, MedPAC presented its 2026 Medicare rate recommendations to Congress. Those recommendations are: Hospital inpatient and outpatient services – the rate increase in current law plus one percent. MedPAC also reiterated its past recommendation that Medicare redistribute current Medicare disproportionate share (Medicare DSH) and uncompensated care payments through MedPAC’s own mechanism, the Medicare Safety-Net Index (MSNI) it introduced in 2023, maintaining that doing so, when supplemented with an additional $4 billion in [...]

joe2025-03-20T14:44:09-04:00March 25, 2025|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

DeBrunner Consultants Lead NPA Forum Session

DeBrunner & Associates’ Pennsylvania managing director Michael Chirieleison and senior policy analyst Janel Gleeson led a session on “State and PACE Organization Efforts to Raise Awareness About PACE” during the National PACE Association’s 2025 Spring Policy Forum in Washington, D.C. last week. PACE is a joint Medicare/Medicaid program through which older adults meet their health care needs in the community instead of going to a nursing home or other care facility. During the two-day forum, congressional staff and experts on PACE programs shared their perspectives on policies and issues affecting both the PACE model of care and the environment in [...]

joe2025-03-19T12:41:08-04:00March 24, 2025|Pennsylvania, Pennsylvania Medicaid, Pennsylvania Medical Assistance|

Federal Health Policy Update for March 20

The following is the latest health policy news from the federal government for March 14-20. Some of the language used below is taken directly from government documents. The White House The White House has rescinded Executive Order 13994 of January 21, 2021, titled “Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats.” In response to this action, CMS rescinded its November 22, 2022 memo “The Importance of Timely Use of COVID-19 Therapeutics,” the purpose of which, according the memo, was “…to highlight the importance of providing timely access to available COVID-19 therapeutics to patients who test positive [...]

joe2025-03-20T16:00:25-04:00March 20, 2025|340b, Centers for Medicare & Medicaid Services, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

If ACA Funding for Medicaid Expansion Were to be Cut…

When Congress enacted the Affordable Care Act in 2010 it offered states a powerful incentive to expand their criteria for Medicaid eligibility: money to pay for most of that expansion. Under that law, the federal government pays 90 percent of the cost of providing Medicaid-covered services to individuals who became eligible for the program under the expanded criteria. So far, 41 states and the District of Columbia have taken advantage of this enhanced funding and 11 million additional people have enrolled in the Medicaid program as a result. But what would happen if that enhanced federal Medical Assistance percentage – [...]

joe2025-03-13T17:26:22-04:00March 17, 2025|Affordable Care Act, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH|

Federal Health Policy Update for March 13

The following is the latest health policy news from the federal government for March 7-13. Some of the language used below is taken directly from government documents. Congress Funding the Federal Government Unless Congress passes spending legislation, funding for the federal government will expire at 12:01 a.m. this Saturday, March 15. This week, the House passed a continuing resolution that would fund the federal government through the end of the 2025 federal fiscal year. The bill extends telehealth flexibilities, the Acute Hospital Care at Home program, and other health extenders through September 30, 2025. The bill also delays cuts to [...]

joe2025-03-13T15:54:07-04:00March 13, 2025|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, MACPAC, 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, Telehealth|

MedPAC Meets

MedPAC’s commissioners held their latest public meetings on Thursday, March 6 and Friday, March 7. The subjects on the meetings’ agenda were: reforming Medicare physician fee schedule updates and improving the accuracy of relative payment rates reducing beneficiary cost-sharing for Medicare-covered outpatient services at critical access hospitals Medicare insurance agents Medigap mandated report: payment for ground ambulance services examining home health care use among Medicare Advantage enrollees institutional special needs plans reducing beneficiary cost-sharing for Medicare-covered outpatient services at critical access hospitals Go here for summaries of the issues and key points and links to the presentations delivered by MedPAC staff and [...]

joe2025-03-11T10:52:28-04:00March 12, 2025|Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for March 6

The following is the latest health policy news from the federal government for March February 28 – March 6. Some of the language used below is taken directly from government documents. Congress The current continuing resolution funding the federal government expires on March 14. Leaders intend to propose a long-term continuing resolution through the end of the current federal fiscal year in September. The likelihood of success of that approach is uncertain. Separately, a number of health care extenders, including preventing cuts to Medicaid disproportionate share (Medicaid DSH), an extension of telehealth flexibilities, an extension of the Acute Hospital Care [...]

joe2025-03-06T16:39:50-05:00March 6, 2025|Centers for Medicare & Medicaid Services, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met publicly last week in Washington, D.C. The following is MACPAC’s own summary of its meeting. During MACPAC’s February 2025 meeting, staff presented four draft policy recommendations to address challenges related to transitions from pediatric to adult care for children and youth with special health care needs (CYSHCN). The draft recommendations reflect the Commission’s feedback from the December and January meetings. The recommendations include requiring states to develop a strategy for transitions of care for CYSHCN, which includes developing an individualized transition of care plan and making the strategy publicly [...]

joe2025-03-05T09:14:32-05:00March 5, 2025|MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid regulations|