Policy Updates

Before Recess, Congress Contemplates Medicaid

Before the current session of Congress comes to a close, lawmakers may consider a number of Medicaid issues. Among them: The future of Medicaid eligibility for those who enrolled in the program as a result of special provisions introduced in response to COVID-19. The process for reviewing the future eligibility of those currently enrolled in Medicaid. A movement to extend the current, temporary 12 months of postpartum Medicaid eligibility for new mothers and their newborns beyond the end of the current public health emergency. A gradual phasing out of the enhanced federal Medicaid matching funds states currently receive. Learn more [...]

iqtsupport2022-12-07T06:00:25-05:00December 7, 2022|Congress, Medicaid|

FEDERAL HEALTH POLICY UPDATE FOR December 1

The following is the latest health policy news from the federal government for the week of November 28 to December 1. Some of the language used below is taken directly from government documents. 340B HHS and its Health Resources and Services Administration (HRSA) have proposed revising the current 340B administrative dispute resolution process. Since the current process was introduced in 2020 HRSA has encountered policy and operational challenges with its implementation and now proposes revising it and is soliciting comment on its proposed new approach. Changes include changing the nature of the dispute resolution process, using different kinds of professionals [...]

States Seek Certainty on End of PHE

The country’s states want a clearer idea of when the official COVID-19 public health emergency will end – and along with it, the continuous Medicaid eligibility that remains a major component of the federal attempt to ensure health care coverage for millions of Americans during the pandemic. Even though two administrations have now regularly renewed the PHE for three-month periods and the current administration has promised governors 60 days’ notice of when the PHE will end, the nation’s Medicaid directors have written to congressional leaders asking for Congress to “…provide states with certainty around the end of the Medicaid continuous [...]

iqtsupport2022-11-30T06:00:58-05:00November 30, 2022|COVID-19, Medicaid|

Federal Health Policy Update for November 17

The following is the latest health policy news from the federal government for the week of November 11 to 17. Some of the language used below is taken directly from government documents. Provider Relief Fund Providers that cited extenuating circumstances for failing to submit Provider Relief Fund financial reports on time for reporting period 3 and were approved to submit their reports late must submit those late reports by December 2. Learn more here. Centers for Medicare & Medicaid Services CMS has posted three downloadable sample formats that hospitals can use to meet federal requirements for posting in a machine-readable [...]

iqtsupport2022-11-17T17:29:00-05:00November 17, 2022|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Medicaid, Medicare, Telehealth|

117th Congress’s Waning Hours

In addition to its biggest challenge – funding the federal government, authorization for which ends on December 16 – Congress has a number of health care issues on its agenda that at least some lawmakers and health care industry stakeholders would like to see it address before the year ends. Those issues include the cut in Medicare payments to physicians scheduled to take place on January 1; the desire of many to make permanent some of the flexibilities to use telehealth that were temporarily authorized in response to the COVID-19 public health emergency; additional pandemic funding for new vaccines, new [...]

iqtsupport2022-11-17T06:00:49-05:00November 17, 2022|Congress, COVID-19, Medicare, Medicare reimbursement policy, Telehealth|

Medicaid and Children’s Behavioral Health

In response to the growing behavioral health challenges children face, including the need for inpatient hospitalization, the country’s Medicaid directors recently addressed the question of how Medicaid can best help tackle this challenge. The directors thought their programs could be most helpful in three ways: preventing crises by providing care and supports improving specialized inpatient psychiatric care supporting the return of patients to the community Learn more about how the Medicaid directors think this can be done and what some of them already are doing in the National Association of Medicaid Directors blog article “How Medicaid is Making a Difference [...]

iqtsupport2022-11-15T06:00:44-05:00November 15, 2022|Medicaid|

Federal Health Policy Update for November 10

The following is the latest health policy news from the federal government for the week of November 7 to 10. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published a notice advising teaching hospitals that they have until November 18 to ask Medicare to reconsider their per resident amounts or resident caps as shown in the Hospital Cost Report Information System (HCRIS) associated with cost reports that, as of July 1, 2022, were not reopenable. Learn more from this CMS notice. Due to an unplanned system outage of [...]

iqtsupport2022-11-10T16:23:21-05:00November 10, 2022|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC|

Health Insurance Markets Remain Highly Concentrated

The health insurance market was highly concentrated in 42 of the 50 states in 2019 and 2020 – the continuation of a trend identified in 2010 that has persisted ever since, according to a new report by the U.S. Government Accountability Office. The GAO considers a market concentrated if three or fewer insurers in a state have 80 percent of that market. Using Centers for Medicare & Medicaid Services health insurance enrollment data, the GAO looked at three distinct aspects of markets – individual policies, small group policies, and large group coverage – and found that Each of the three [...]

iqtsupport2022-11-10T06:00:51-05:00November 10, 2022|Affordable Care Act, Uncategorized|

Innovation Center Updates Strategy

The Center for Medicare and Medicaid Innovation has updated its strategy for person-centered innovation. The Innovation Center’s new strategy document, “Person-Centered Innovation – An Update on the Implementation of the CMS Innovation Center’s Strategy,” outlines steps the agency hopes will foster greater coordination and cooperation between primary care providers and medical specialists through the introduction and refinement of new payment models. The new document outlines five strategic objectives: drive accountable care advance health equity support innovation address affordability partner to achieve system transformation In support of these objectives, the Innovation Center describes recent accomplishments – most them process measures rather [...]

iqtsupport2022-11-09T06:00:32-05:00November 9, 2022|Center for Medicare and Medicaid Innovation, CMMI|

MedPAC Meets

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: differences in quality measure results across Medicare populations policy options for increasing Medicare payments to primary care clinicians aligning fee-for-service payment rates across ambulatory settings mandated report: evaluation of a prototype design for a post-acute care prospective payment system supporting Medicare safety-net hospitals MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are not binding on Congress or the administration, MedPAC is [...]

iqtsupport2022-11-08T06:00:13-05:00November 8, 2022|hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|