Policy Updates

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. During the April 2022 Medicaid and CHIP Payment and Access Commission meeting, the Commission voted to approve a package of recommendations to: create a new approach for monitoring access to care for Medicaid beneficiaries; improve vaccine access for adult Medicaid beneficiaries; improve the oversight and transparency of directed payments in Medicaid managed care; and encourage the adoption of health information technology (IT) in behavioral health. The recommendations will appear in MACPAC’s June report to [...]

iqtsupport2022-04-13T06:00:07-04:00April 13, 2022|Alternative payment models, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations|

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: addressing high prices of drugs covered under Medicare Part B initial findings from MedPAC's analysis of Part D data on drug rebates and discounts segmentation in the stand-alone Part D prescription drug plan market leveraging Medicare policies to address social determinants of health an approach to streamline and harmonize Medicare’s portfolio of alternative payment models aligning fee-for-service payment rates across ambulatory settings MedPAC is an independent congressional agency that advises Congress [...]

iqtsupport2022-04-12T06:00:14-04:00April 12, 2022|Alternative payment models, Medicare, MedPAC|

Surprise Bill Law’s “Good-Faith Estimate” to Challenge Providers

The requirement to give patients “good-faith estimates” of the costs associated with planned medical procedures will pose one of the biggest challenges to providers seeking to meet the implementation requirements of the 2020 No Surprises Act, which was intended to protect consumers from surprise medical bills, especially from providers not in their health insurers’ provider networks. Under the law’s implementing regulations, providers are often responsible for delivering good-faith estimates to their patients within 24 hours of scheduling a procedure. Eventually, the “convening provider” also will need to anticipate patients’ potential costs beyond the procedure itself and collect estimates for those [...]

iqtsupport2022-04-11T06:00:59-04:00April 11, 2022|hospitals|

Federal Health Policy Update for Thursday, April 7

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, April 7. Some of the language used below is taken directly from government documents. White House The administration is proposing to address a flaw in the Affordable Care Act often referred to as the “family glitch.” Under the ACA, people who do not have access to “affordable” health insurance through their jobs may qualify for a premium tax credit to purchase coverage on the ACA’s health insurance marketplaces. Current regulations define employer-based health insurance as “affordable” if the coverage for the employee [...]

iqtsupport2022-04-07T17:12:01-04:00April 7, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for Friday, April 1

The following is the latest health policy news from the federal government as of 2:30 p.m. on Friday, April 1. Some of the language used below is taken directly from government documents. Provider Relief Fund After April 5, this program also will stop accepting claims for administering vaccines to uninsured individuals. See this notice for further information about both deadlines for submitting claims. Proposed Medicare Payment Regulations for FY 2023 CMS has published its proposed inpatient rehabilitation facility (IRF) prospective payment system and IRF quality reporting program for FY 2023. The agency proposes a 2.8 percent net increase in Medicare [...]

iqtsupport2022-04-01T17:09:26-04:00April 1, 2022|Accountable Care Organization, ACO, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, health equity, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for Wednesday, March 30

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, March 30. Some of the language used below is taken directly from government documents. Provider Relief Fund The Provider Relief Fund last week distributed more than $413 million to more than 3600 providers across the country, the fourth round of Phase 4 payments since those payments began last November. This is in addition to nearly $7.5 billion in American Rescue Plan (ARP) Rural payments over the past four months. HHS’s Health Resources and Services Administration (HRSA), which administers the Provider Relief Fund, [...]

iqtsupport2022-03-30T17:28:16-04:00March 30, 2022|Accountable Care Organization, ACO, Centers for Medicare & Medicaid Services, CMMI, Congress, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare reimbursement policy|

Medicaid as a Tool for Addressing Racial Health Inequities

Medicaid can be an important tool for addressing racial health inequities, the Kaiser Family Foundation suggests in a new issue brief. Among the measures involving Medicaid that might be undertaken to address racial health inequities and addressing social determinants of health, the brief suggests (in words taken directly from the issue brief): One significant action that would help close coverage disparities for people of color is adoption of the ACA Medicaid expansion in the 12 non-expansion states. Other expansions of Medicaid eligibility could also address racial disparities in coverage and access to care. Making it easier for eligible people to [...]

iqtsupport2022-03-25T06:00:31-04:00March 25, 2022|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, Medicaid, Medicaid managed care, Medicaid regulations|

Hospitals, Insurers, City Government Launch Health Equity Effort

The pursuit of health equity is the subject of a new collaboration between health systems, health insurers, and a big city government. The new effort, dubbed “Accelerate Health Equity,” will seek to bring “…together organizations across the region to produce tangible improvement in health inequities, and ultimately achieve measurable, positive changes in health outcomes in Philadelphia.” Among the participants in the endeavor are AmeriHealth Caritas, Children’s Hospital of Philadelphia, the City of Philadelphia, Drexel University, Independence Blue Cross, Jefferson Health, Main Line Health, Penn Medicine, Philadelphia College of Osteopathic Medicine, Temple Health, and Trinity Health Mid-Atlantic. The group envisions its [...]

iqtsupport2022-03-24T06:00:51-04:00March 24, 2022|health equity, Pennsylvania|

Telehealth Boomed During Pandemic

The COVID-19 pandemic sparked tremendous growth in the use of telehealth services among Medicare beneficiaries, according to the Department of Human Services’ Office of the Inspector General. During the first year of the public health emergency, with many previous limits on the use of telehealth temporarily waived, more than 28 million Medicare beneficiaries used telehealth beneficiaries used 88 times more telehealth services during the first year of the pandemic than in the previous year beneficiaries used telehealth to receive 12 percent of their services beneficiaries most commonly used telehealth for office visits beneficiaries used telehealth for 43 percent of behavioral [...]

iqtsupport2022-03-23T13:00:32-04:00March 23, 2022|COVID-19, Medicare regulations, Telehealth|

Federal Health Policy Update for Tuesday, March 22

The following is the latest health policy news from the federal government as of 2:30 p.m. on Tuesday, March 22. Some of the language used below is taken directly from government documents. Provider Relief Fund As of March 22 at 11:59 p.m. (eastern) the HRSA (Health Resources and Services Administration) COVID-19 Uninsured Program will stop accepting claims for testing and treatment due to lack of funds and on April 5 at 11:59 p.m. (eastern) the HRSA COVID-19 Uninsured Program and COVID-19 Coverage Assistance Fund will stop accepting vaccination claims due to a lack of funds. HRSA has released additional information [...]

iqtsupport2022-03-22T20:50:28-04:00March 22, 2022|340b, Accountable Care Organization, ACO, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare reimbursement policy, Telehealth|