Policy Updates

States Prepare to Unravel Pandemic Medicaid Expansion

As the COVID-19 public health emergency once again appears, at least for the moment, to be winding down, state governments are preparing for how to undo the Medicaid and Children’s Health Insurance Program expansions mandated by Congress and return to their pre-COVID eligibility criteria for the two major health care safety-net programs. Under the temporary federal expansion of Medicaid and CHIP eligibility during the pandemic’s early days, states received enhanced federal matching funds for those programs in exchange for expanding their eligibility criteria and agreeing not to reconsider enrollees’ eligibility for the duration of the PHE. With the prospect of [...]

iqtsupport2022-03-22T06:00:53-04:00March 22, 2022|COVID-19, Medicaid|

MedPAC Makes 2023 Medicare Payment Recommendations

The Medicare Payment Advisory Commission has released its March 2022 Report to the Congress: Medicare Payment Policy. The report includes MedPAC’s recommendations for Medicare payments in 2023. For the coming year, MedPAC recommends the following changes in Medicare fee-for-service payments: hospital inpatient payments – increase 2.5% hospital outpatient payments – increase 2.0% long-term care hospital payments – increase approximately 2.0% outpatient dialysis payments – increase 1.2% physician, ambulatory surgical center, and hospice payments – no change skilled nursing facility, home health, and inpatient rehabilitation facility payments – reduce 5.0% The report also reviews the status of Medicare Advantage and the [...]

iqtsupport2022-03-21T06:00:52-04:00March 21, 2022|Medicare reimbursement policy, MedPAC|

Feds Plan for End of Aid for Certain COVID Services

As of March 22, 2022 at 11:59 p.m. (eastern) the HRSA COVID-19 Uninsured Program will stop accepting claims for testing and treatment due to lack of funds and on April 5, 2022 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. Today, the Department of Health and Human Services’ Health Resources and Services Administration (HRSA), which runs the Provider Relief Fund program, has provided additional information about this significant change in federal COVID policy with the publication of two new documents: HRSA COVID-19 Uninsured [...]

iqtsupport2022-03-17T16:03:40-04:00March 17, 2022|Uncategorized|

Federal Health Policy Update for Wednesday, March 16

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, March 16. Some of the language used below is taken directly from government documents. Provider Relief Fund On March 22, 2022 at 11:59 p.m. (eastern), the HRSA COVID-19 Uninsured Program will stop accepting claims for testing and treatment due to lack of funds. On April 5, 2022 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. See the announcement of these changes. Providers that received Provider [...]

iqtsupport2022-03-16T17:41:14-04:00March 16, 2022|Centers for Medicare & Medicaid Services, Coronavirus, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid upper-payment limit, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for Thursday, March 10

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, March 10. Some of the language used below is taken directly from government documents. White House The White House has posted a transcript of the March 2 press briefing given by its COVID-19 response team to outline the administration’s National COVID-19 Preparedness Plan. 340B Eligibility Protection and Telehealth Extensions in the Omnibus Spending Bill Providers that feared they might lose their eligibility to continue participating in the 340B prescription drug discount program because they have fallen below that program’s Medicare disproportionate share [...]

iqtsupport2022-03-10T17:37:25-05:00March 10, 2022|Centers for Medicare & Medicaid Services, Congress, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicare, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy, MedPAC, Telehealth|

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 March 2022 meeting began with a follow-up discussion on directed payments in managed care. This presentation reviewed a package of five proposed recommendations related to: improving the transparency of existing directed payment approval documents, rate certifications, and evaluations; collecting new provider-level data on directed payment spending; further clarifying directed payment goals and their relationship to network adequacy requirements; providing guidance for more meaningful, multi-year assessments of directed payments; and improving the coordination of [...]

iqtsupport2022-03-08T10:50:01-05:00March 8, 2022|MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid long-term services and supports, Medicaid managed care, Medicaid regulations, Medicaid upper-payment limit|

Federal Health Policy Update for Wednesday, March 2

The following is the latest health policy news from the federal government as of 3:00 p.m. on Wednesday, March 2. Some of the language used below is taken directly from government documents. Provider Relief Fund The Provider Relief Fund FAQ has been updated with three modified questions that address 1099 forms and procedures involved in returning Provider Relief Fund money to the federal government. Find the three updates, all marked “Modified 2/25/2022,” on pages 6 and 8 of the Provider Relief Fund FAQ. Federal Response to Surprise Billing Regulation Court Decision Last week a federal court decision invalidated a major [...]

iqtsupport2022-03-02T17:41:03-05:00March 2, 2022|Accountable Care Organization, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Hospitals Question Feds’ Plan for Doling Out New GME Slots

Last year Congress created 1000 new Medicare-supported graduate medical education residency slots. This year hospitals are unhappy about how regulators propose assigning those new slots. At issue, according to those who responded to CMS’s proposal for apportioning the slots, is the Centers for Medicare & Medicaid Services’ heavy reliance on assigning those slots to providers in Health Professional Shortage Areas (HPSAs). While the legislation calls for incorporating HPSAs into the distribution methodology, provider interests point out, it did not call for the degree of reliance on HPSAs that regulators propose. Doing so, they insist, is contrary to congressional intent. Learn [...]

iqtsupport2022-03-02T06:00:29-05:00March 2, 2022|hospitals, Medicare|

FEDERAL HEALTH POLICY UPDATE FOR FRIDAY, FEBRUARY 25

The following is the latest health policy news from the federal government as of 2:30 p.m. on Friday, February 25. Some of the language used below is taken directly from government documents. Provider Relief Fund HHS made more than $560 million in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 4100 providers across the country this week. According to HHS, approximately 86 percent of all Phase 4 applications have now been processed and the remaining applications will continue to be processed throughout early 2022. To date, HHS has distributed $11.5 billion of the $17 billion allocated [...]

iqtsupport2022-02-25T16:45:53-05:00February 25, 2022|ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, Medicare DSH, Medicare regulations, MedPAC|

Federal Health Policy Update for Friday, February 18

The following is the latest health policy news from the federal government as of 3:00 p.m. on Friday, February 18. Some of the language used below is taken directly from government documents. White House The White House has posted a transcript of the February 16 press briefing given by its COVID-19 response team and public officials. Go here to see the slides presented during the briefing. Centers for Medicare & Medicaid Services Health Policy Update CMS has issued a request for information (RFI) seeking feedback on topics related to Medicaid and the Children’s Health Insurance Program (CHIP), such as enrolling [...]

iqtsupport2022-02-18T17:15:56-05:00February 18, 2022|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, Medicaid, Medicare, Medicare reimbursement policy, MedPAC|