Policy Updates

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 [...]

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 [...]

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 [...]

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), [...]

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 [...]

CMS Warns States About Medicaid Renewals

Some states are falling short in their efforts to process Medicaid renewal applications and are inappropriately finding too many people ineligible to continue participating in the program, the Centers of Medicare & Medicaid Services has written in a letter it sent to all 50 states. In this letter, CMS wrote that As the Centers for Medicare & Medicaid Services (CMS) has worked with states on the return to regular eligibility operations following the end of the Medicaid continuous enrollment condition, we have identified issues where states are out of compliance with renewal requirements. CMS has worked with those states individually [...]

2023-09-05T06:00:57-04:00September 5, 2023|Uncategorized|

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 [...]

Court Again Sets Back No Surprises Act Implementation

For the second time in less than a month, a federal court has rejected the manner in which federal agencies are implementing the Independent Dispute Resolution process of the No Surprises Act, the 2020 law designed to protect consumers from surprise medical bills. In its ruling the court found that the process established by federal agencies to establish the Qualifying Payment Amount, or QPA, which is the median rate insurers pay for in-network services and a critical factor in adjudicating payment disputes between providers and payers, inappropriately permits insurers to depress that rate – a result the court likened to [...]

2023-08-30T06:00:15-04:00August 30, 2023|Centers for Medicare & Medicaid Services|

Supply of Nursing Home Beds Declining

The number of nursing home beds in the U.S. is fast declining, according to a new analysis commissioned by the American Health Care Association, a nursing home trade group. According to the study, 21 percent of nursing home operators have downsized – dropped beds or units. 55 percent have turned away people seeking nursing home beds. 48 percent have waiting lists. 579 facilities have closed since 2020, and along with them, the supply of nursing home beds fell by more than 45,000. Nursing home operators cite a number of reasons for the decline, including current reimbursement practices – especially for [...]

2023-08-28T06:00:39-04:00August 28, 2023|hospitals, Medicaid, post-acute care|

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 [...]

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