Policy Updates

FEDERAL HEALTH POLICY UPDATE FOR THE WEEK OF SEPTEMBER 19-27

The following is the latest health policy news from the federal government for the week of September 19-27.  Some of the language used below is taken directly from government documents. White House The White House has issued a fact sheet summarizing new actions and funding to address the overdose epidemic and support recovery as part of its September “National Recovery Month.” Awarding $1.5 billion for all states and territories to address addiction and the opioid crisis. Investing more than $104 million to expand substance use treatment and prevention in rural communities. Investing $20.5 million to increase access to recovery supports. [...]

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. Supporting the discussion were the following briefing papers: Background on Medicaid Race and Ethnicity Data Collection and Reporting State Strategies and Stakeholder Engagement for Unwinding the Public Health Emergency Continuous Coverage Requirement Improving Rate Setting and Risk Mitigation in Medicaid Managed Care Principles for Assessing Medicaid Nursing Facility Payments Relative to Costs Countercyclical Disproportionate Share Hospital Policies Medicaid Coverage of Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease Review of Proposed Rule on Core Set Reporting and Congressional Request for [...]

Feds Pursue Next Regs for Surprise Billing Law

In their continuing effort to implement the complex No Surprises Act, the 2020 law that seeks to prevent consumers from receiving surprise medical bills, federal regulators are now turning their attention to how providers and payers should inform insured individuals about the costs they may incur for procedures and purchases. Specifically, the federal agencies with jurisdiction over the law and its implementation – the Department of Health and Human Services, the federal Office of Personnel Management, the Internal Revenue Service, the Department of the Treasury, the Department of Labor, and the Employee Benefits Security Administration – have issued a request [...]

2022-09-22T13:00:58-04:00September 22, 2022|Uncategorized|

Risk Adjustment Has Impact on Medicare Readmissions Program

The use of social risk adjustment has helped reduce differences in the penalties assessed to safety-net hospitals and other hospitals by Medicare’s hospital readmissions reduction program, according to a new study. According to the study published in the journal Health Affairs, Seven studies found that adding social risk factors to the program’s base risk-adjustment model (which adjusts only for age, sex, and comorbidities) reduced differences in risk-adjusted readmissions and penalties between safety-net hospitals and other hospitals. Three studies found that peer grouping, the HRRP’s current approach to social risk adjustment, reduced penalties among safety-net hospitals. Two studies found that differences [...]

2022-09-22T06:00:18-04:00September 22, 2022|Medicare, Medicare reimbursement policy|

Hospital Financial Woes Continue and Will Persist

The immediate financial future for many hospitals is bleak, according to a new study. The study, by the health care management consulting company Kaufman Hall, concludes that “Margins remain depressed relative to pre-pandemic levels.” “More than half of hospitals are projected to have negative margins through 2022.” “Expenses are significantly elevated from pre-pandemic levels.” “Hospitals have faced a profound financial toll.” “Ultimately, U.S. hospitals are likely to face billions of dollars in losses in 2022 under both optimistic and pessimistic." The study cites the COVID-19 pandemic and inflation among the leading causes of hospitals’ financial distress. Learn more from the [...]

2022-09-21T06:00:06-04:00September 21, 2022|Uncategorized|

FEDERAL HEALTH POLICY UPDATE FOR THE WEEK OF SEPTEMBER 12-16

The following is the latest health policy news from the federal government for the week of September 12-16.  Some of the language used below is taken directly from government documents. No Surprises Act The Department of Health and Human Services, the federal Office of Personnel Management, the Internal Revenue Service, the Department of the Treasury, the Department of Labor, and the Employee Benefits Security Administration have issued a request for information (RFI) seeking stakeholder comment on how to implement the No Surprises Act’s requirement that health care providers and payers give explanations of benefits and good-faith estimates of costs for [...]

Federal Health Policy Update for the Week of September 5-12

The following is the latest health policy news from the federal government for the week of September 5-12.  Some of the language used below is taken directly from government documents. The White House The White House has published a fact sheet on the administration’s plan to get Americans an updated COVID-19 shot and to manage COVID-19 this fall.  The major components of the plan are providing access to free, updated vaccines; ensuring easy access to testing and treatment; encouraging safe practices; and preparing for potential surges and new variants.  Find that fact sheet here. The White House’s COVID-19 response team [...]

Report Details History of Provider Relief Fund

A new report chronicles the history, evolution, and workings of the Provider Relief Fund, which was financed by Congress to help health care providers and their patients through the worst of the COVID-19 public health emergency. The Urban Institute report “The COVID-19 Provider Relief Fund:  Following How the US Department of Health and Human Services Distributed $178 Billion,” traces the history of the Provider Relief Fund and how it distributed the money allocated to it. It also outlines how the fund evolved, how the money was distributed to different types of providers for different reasons, and the criticisms leveled against [...]

2022-09-09T13:00:52-04:00September 9, 2022|COVID-19|

CMS Seeks Comment on Efficiency, Administrative Burdens, and Health Equity

The Centers for Medicare & Medicaid Services has issued a request for information “…seeking public input on accessing healthcare and related challenges, understanding provider experiences, advancing health equity, and assessing the impact of waivers and flexibilities provided in response to the COVID-19 Public Health Emergency.” According to a CMS news release, The Make Your Voice Heard: Promoting Efficiency and Equity Within CMS Programs RFI furthers CMS’ commitment to engaging and learning from partners, communities, and individuals across the health system to inform how we can better support the populations we serve. The agency also explains that CMS is seeking to [...]

MedPAC Meets

The Medicare Payment Advisory Commission held public meetings on September 1 and 2.  Among the subjects discussed during the meeting were: Reforming Medicare’s wage index system – “the commission remains concerned about Medicare’s current wage index policies, including the system’s inaccuracy, the circularity of hospital-reported data, the large volume of permitted exceptions, and administrative complexity and MedPAC commissioners discussed an alternative wage index methodology.” Context for Medicare payment policy – an annual discussion. Standardizing benefits in Medicare Advantage plans – cost sharing for Part A and Part B services Medicare Advantage encounter data – “MedPAC has been concerned about the [...]

2022-09-08T06:00:28-04:00September 8, 2022|Medicare reimbursement policy, MedPAC|
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