Policy Updates

Federal Health Policy Update for January 5

The following is the latest health policy news from the federal government for December 23 through January 5. Some of the language used below is taken directly from government documents. No Surprises Act HHS, the Department of Labor, and the Department of the Treasury have announced increases in the administrative fee for initiating the No Surprises Act’s Independent Dispute Resolution (IDR) process and for certified IDR entities. Learn more about the administrative fee change here and about the certified IDR entity fee change here. Both changes took effect on January 1. HHS, the Department of Labor, and the Department of the [...]

iqtsupport2023-01-05T17:15:07-05:00January 5, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for December 22

The following is the latest health policy news from the federal government for the week of December 19-22. Some of the language used below is taken directly from government documents. Congress As of this writing, Congress continues to work on an FY 2023 omnibus spending bill: the Senate has passed it but the House has not yet addressed it. Highlights of what negotiators have agreed to – but that have not yet been adopted – include: Preventing the additional four percent Medicare sequester for two years. Reducing by more than half the 4.5 percent cut in Medicare payments to physicians [...]

iqtsupport2022-12-22T17:30:38-05:00December 22, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, hospitals, Medicaid, Medicare, Medicare bad debt reimbursement, Medicare regulations, Medicare reimbursement policy, Telehealth|

Paxlovid Will Soon Cost Patients

Free Paxlovid treatment for COVID-19 will soon be a thing of the past for many people because in the coming months the federal government plans to stop paying for the drug for everyone who needs it. Nearly six million Americans so far have taken Paxlovid after being diagnosed with COVID, but by the middle of 2023 the federal government is expected to stop footing the bill. Currently, it pays $530 a dose – a discounted price. When that happens the drug may become far less accessible. Because Paxlovid is only authorized under federal emergency use authorization, Medicare drug plans are [...]

iqtsupport2022-12-16T06:00:16-05:00December 16, 2022|COVID-19, Medicaid, Medicare|

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15. Some of the language used below is taken directly from government documents. White House The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans. Learn more about the plan from this White House fact sheet and go here for a transcript of the White House [...]

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The December 2022 MACPAC meeting began with a Commission discussion on two potential recommendations for improving Medicaid race and ethnicity data reporting. As part of its commitment to prioritizing health equity in all of its work, the Commission is focused on how to improve Medicaid race and ethnicity data collection and reporting. In October, staff presented findings from a literature review and key stakeholder interviews, as well as possible approaches for improving the collection [...]

iqtsupport2022-12-15T06:00:20-05:00December 15, 2022|hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care|

COVID Flexibilities Apply to RSV, Flu, HHS Secretary Tells Governors

The same flexibilities that the federal government established to help states respond to the COVID-19 emergency can be used to respond to the current RSV and flu challenges, Health and Human Services Secretary Xavier Becerra has written to the nation’s governors. According to the Becerra letter, … the Administration has exercised regulatory flexibilities to help health care providers and suppliers continue to respond to COVID-19. These flexibilities – while critical in addressing the COVID-19 pandemic – can also help address many of the challenges you face during the spread of non-COVID-19 illnesses, including RSV and flu. They remain available to [...]

iqtsupport2022-12-14T13:00:01-05:00December 14, 2022|COVID-19|

MedPAC Considers 2023 Medicare Rates at December Meeting

The government agency that advises Congress on Medicare payment matters met publicly in Washington, D.C. last week. During the virtual meeting, members of the Medicare Payment Advisory Commission discussed and debated: Assessing payment adequacy and updating payments: hospital inpatient and outpatient services and supporting Medicare safety-net hospitals – commissioners discussed a proposal to increase FY 2024 rates one percentage point more than current law prescribes. Commissioners also discussed additional steps they might take to provide better support to safety-net hospitals, which they described as “…hospitals with high shares of low-income Medicare patients.” Status report: ambulatory surgical center services. Assessing payment [...]

iqtsupport2022-12-14T06:00:43-05:00December 14, 2022|Congress, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

CBO Looks For Cost-Cutting Opportunities

The Congressional Budget Office periodically issues a compendium of policy options for changing federal tax and spending policies in particular areas and reducing federal spending. For each option the CBO presents an estimate of its effect on the budget without making recommendations either in favor of or against those options. The latest update of options includes a number with potential implications for health care providers, including: changing the cost-sharing rules for Medicare and restricting medigap insurance reducing Medicare Advantage benchmarks reducing Medicare’s coverage of bad debt consolidating and reducing federal payments for graduate medical education at teaching hospitals establishing caps [...]

iqtsupport2022-12-13T06:00:58-05:00December 13, 2022|deficit reduction, hospitals, Medicaid, Medicare, Medicare bad debt reimbursement|

Tough Decision Looms for Rural Hospitals

Amid growing number of rural hospitals closing for financial reasons, the federal government believes it has come up with a solution to help slow those closings: a new provider type called a “Rural Emergency Hospital” that offers struggling facilities roughly $3 million a year in cash. The catch? To receive the money they must stop providing inpatient services and transfer patients who need such care to other facilities. More than 1700 rural U.S. hospitals will have the option of participating in the program, but while the money may save some hospitals, those hospitals will never be the same. Doing so [...]

iqtsupport2022-12-12T06:00:25-05:00December 12, 2022|hospitals|

Federal Health Policy Update for December 8

The following is the latest health policy news from the federal government for the week of December 4-8. Some of the language used below is taken directly from government documents. No Surprises Act CMS has published an FAQ about implementation of good faith estimates for uninsured and self-pay patients under the No Surprises Act. In the FAQ the agency explains that it will extend enforcement discretion for situations in which good faith estimates do not include expected charges from co-providers or co-facilities. This enforcement discretion was expected to end on January 1 but CMS now writes that it will remain [...]

iqtsupport2022-12-08T17:09:11-05:00December 8, 2022|Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid regulations, Medicare, Medicare bad debt reimbursement, Medicare cuts, Medicare regulations, Medicare reimbursement policy, Telehealth|