Policy Updates

Prescription Drug Bill Would Kill Two Years of Medicaid DSH Cuts

Two years of Medicaid DSH cuts would be eliminated under a new prescription drug bill released last week by the Senate Finance Committee. The Prescription Drug Pricing Reduction Act includes a provision that would eliminate two years of Affordable Care Act-mandated cuts in the allocation of federal money to the states for Medicaid disproportionate share hospital payments (Medicaid DSH). Those cuts have been delayed several times by Congress but were scheduled to begin in October of 2019 and run through federal FY 2025, only to be delayed again twice by continuing resolutions adopted by Congress to fund the federal government [...]

iqtsupport2019-12-10T13:00:30-05:00December 10, 2019|Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s December agenda were: Assessing payment adequacy and updating payments: Physician and other health professional services Assessing payment adequacy and updating payments: Ambulatory surgical center services Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; Mandated report: Expanding the post-acute care transfer policy to hospice Assessing payment adequacy and updating payments: Skilled nursing facility services Assessing payment adequacy and updating payments: Home health care services Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services Assessing payment [...]

iqtsupport2019-12-10T06:00:07-05:00December 10, 2019|Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

Home Health Agencies Expanding Scope of Endeavor

In the coming years, home health agencies will be providing a broader scope of services. With many such agencies already offering medication management technology, remote patient monitoring, image-sharing technology, and mobile apps for e-visits, many are planning to do more. More than a quarter of home health providers plan to move into or expand their telehealth offerings in the coding years and many already provide chronic care services, with more planning to do so in the coming years. Home health providers also are moving into palliative care, veteran-specific services, and mental health services. Behind some of this expansion of scope [...]

iqtsupport2019-12-09T06:00:21-05:00December 9, 2019|Medicare, Telehealth|

Hospitals Sue Over Hospital Price Transparency Requirement

The federal government should be prohibited from implementing its new price transparency requirement for hospitals, a group of hospital trade groups and health systems has declared in a lawsuit against the U.S. Department of Health and Human Services. The requirement exceeds the federal government’s authority, the suit maintains, and its implementation would create an undue burden on hospitals, cost a great deal of money, require hospitals to divulge proprietary information, inhibit competition, and overwhelm their information systems. Even after all of that, the suit claims, consumers would still not have useful information because insurers, not hospitals, are the key in [...]

iqtsupport2019-12-06T06:00:38-05:00December 6, 2019|hospitals, Medicare regulations|

Pennsylvania Moves to Establish its Own Health Insurance Exchange

Pennsylvania plans to move away from participating in the federal health insurance exchange and to establish its own exchange in time for the 2021 open enrollment season. The shift away from using the federal exchange and developing a state-based exchange was approved by Pennsylvania’s General Assembly earlier this year. That shift took a major step forward recently when the state hired a contractor to create the site’s platform. State officials estimate that once the state’s site is up and running it will costs $25 million a year to operate; currently, Pennsylvania pays $95 million a year to participate in the [...]

iqtsupport2019-12-05T06:00:31-05:00December 5, 2019|Affordable Care Act|

MedPAC to Meet Tomorrow

The Medicare Payment Advisory Commission meets this Thursday and Friday in Washington, D.C. MedPAC’s December agenda is dominated by Medicare payment issues: how much Medicare should pay for different types of services in calendar year 2021 and FY 2021. The services to be addressed during the December 5-6 meetings are physician and other health professional services, ambulatory surgical center services, hospital inpatient and outpatient services, skilling nursing facility services, home health services, inpatient rehabilitation facility services, long-term care hospital services, outpatient dialysis services, and hospice services. In addition, MedPAC commissioners will discuss their mandated report on expanding Medicare’s post-acute care [...]

iqtsupport2019-12-04T06:00:06-05:00December 4, 2019|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

High-Deductible Plans Driving Rise in Hospital Bad Debt

Hospital bad debt rose in 2018 after several years of decline, and according to Moody’s, high-deductible health insurance is one of the major drivers of that increase. According to the bond rating agency, non-profit hospitals are seeing growing amounts of bad debt as they struggle, often unsuccessfully, to collect from patients whose high deductibles leave them on the hook for meaningful amounts of care. Kaiser Health News reports that 28 percent of covered workers, nearly half of them working for companies with fewer than 200 employees, now have health plan deductibles of at least $2000. That proportion of individuals with [...]

iqtsupport2019-12-02T06:00:45-05:00December 2, 2019|hospitals|

Hospitals Sue HHS Over Payment Cut

Medicare cut hospital payments $840 million a year more than it should have and now, hospitals are suing to get their money back. According to the lawsuit, Congress authorized Medicare to include a cut of 0.7 percent in hospital inpatient payments through FY 2017 to recoup past Medicare overpayments but Medicare continued the cut, without Congress’s approval, in FY 2018 and FY 2019. The 600 hospitals that filed the suit estimate that the allegedly illegal cut cost them about $200,000 each and now, they want their money back – with interest. Learn more in the Becker’s Hospital Review article “622 [...]

iqtsupport2019-11-26T06:00:10-05:00November 26, 2019|hospitals, Medicare cuts, Medicare reimbursement policy|

Medicaid DSH Cut Delayed

Cuts in Medicaid DSH payments to hospitals will be delayed for another month after Congress passed, and the president signed, a continuing resolution to fund the federal government through December 20. A cut in federal Medicaid disproportionate share (Medicaid DSH) allotments to the states is mandated by the Affordable Care Act and has been delayed several times by Congress. If implemented, Medicaid DSH allotments to the states would be slashed $4 billion in FY 2020 and then $8 billion a year through FY 2025. Cuts in allotments to the states would result in reductions of Medicaid DSH payments to DSH-eligible [...]

iqtsupport2019-11-25T06:00:44-05:00November 25, 2019|Affordable Care Act, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

Administration Reveals Regulatory Priorities for 2020

The Trump administration’s health care regulatory priorities for 2020 have been outlined by the Office of Management and Budget in a newly released “Statement of Regulatory Priorities for Fiscal Year 2020.” The statement, an annual OMB document, organizes the priorities as follows: Facilitating patient-centered markets Fixing health care financing through protecting private insurance and Medicare Fixing health care financing through reforming the individual market Fixing health care financing through making the ACA and Medicaid fiscally sustainable Bringing value to health care through price and quality transparency Bringing value to health care through patient-centered health IT Bringing value to health care [...]

iqtsupport2019-11-22T06:00:34-05:00November 22, 2019|Affordable Care Act, Centers for Medicare & Medicaid Services, Medicaid, Medicaid regulations, Medicare, Medicare regulations|