Policy Updates

Court Halts Medicare Site-Neutral Payment Changes

The Centers for Medicare & Medicaid Services did not have the authority to implement the site-neutral payment system for Medicare-covered outpatient services that it introduced last year, a federal court has concluded. According to the court, CMS exceeded its authority because it …was not authorized to ignore the statutory process for setting payment rates in the Outpatient Prospective Payment System and to lower payment rates only for certain services provided by certain providers. In general, hospitals oppose the movement toward site-neutral payments and independent physician groups support it. The court did not order CMS to reimburse affected physician practices for [...]

iqtsupport2019-09-19T06:00:43-04:00September 19, 2019|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare regulations, Medicare reimbursement policy|

Millions Eligible for Health Insurance Remain Uninsured

More than 15 million Americans who are currently entitled to free or subsidized health insurance are currently uninsured. Among them are 11 million who are eligible for Medicaid but have not applied for benefits and 4.2 million who could afford insurance with the help of federal premium subsidies and either have decided not to take advantage of those subsidies or are unaware of the availability of such subsidies. In addition, another two million people would be eligible for Medicaid if their states expanded their Medicaid program as authorized by the Affordable Care Act. In light of such figures, it is [...]

iqtsupport2019-09-16T06:00:48-04:00September 16, 2019|Affordable Care Act, Medicaid|

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 September agenda were: context for Medicare payment policy the effects of Medicare Advantage “spillover” on Medicare fee-for-service spending and coding evaluation of the hospital readmissions reduction program examining the effects of competitive bidding for diabetes testing supplies and improving payment policies for DMEPOS products excluded from competitive bidding a value incentive program for post-acute-care providers Medicare indirect medical education (IME) policy, concerns, and considerations for revising MedPAC is an independent congressional agency that advises Congress on issues [...]

iqtsupport2019-09-12T09:50:13-04:00September 12, 2019|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

ACA Has Reduced Insurance Disparities

The Affordable Care Act is responsible for a major reduction in the disparity of insurance status among racial and ethnic minorities. According to a new Commonwealth Fund analysis, All U.S. racial and ethnic groups saw comparable, proportionate declines in uninsured rates… However, because uninsured rates started off much higher among Hispanic and black non-Hispanic adults than among white non-Hispanic adults, the coverage gap between blacks and whites declined from 11.0 percentage points in 2013 to 5.3 percentage points in 2017. Likewise, the coverage gap between Hispanics and non-Hispanic whites dropped from 25.4 points to 16.6 points. Learn more about specific [...]

iqtsupport2019-08-23T11:40:37-04:00August 23, 2019|Affordable Care Act, Medicaid|

Uninsured Rate Rose in 2017

The rate of uninsured Americans rose in 2017, the first such increase since implementation of the Affordable Care Act. According to a new Urban Institute study, The increasing uninsurance rate between 2016 and 2017 was driven by losses of private nongroup coverage, such as that purchased in the health insurance marketplaces, and decreases in Medicaid and Children’s Health Insurance Program (CHIP) coverage (-0.4 percentage points each). In addition, Overall, coverage losses were concentrated in the 19 states that did not expand Medicaid eligibility under the Affordable Care Act by July 1, 2017…Between 2016 and 2017, uninsurance held stable in Medicaid [...]

iqtsupport2019-08-21T10:58:26-04:00August 21, 2019|Affordable Care Act, Medicaid|

Medicaid Rolls Could Include Too Many People in Some States

Some states appear to have more Medicaid participants than they do individuals who meet the program’s income eligibility requirements. Or so suggests a new study from the National Bureau of Economic Research. According to the study, an analysis of nine states that expanded their Medicaid program under the Affordable Care Act found 800,000 more Medicaid participants than it did individuals who meet Medicaid’s income eligibility criteria. The study acknowledges that the actual numbers may not be as great because some people qualify for Medicaid based on disabilities and factors other than income. Learn more in the National Bureau of Economic [...]

iqtsupport2019-08-19T11:39:18-04:00August 19, 2019|Affordable Care Act, Medicaid|

Stakeholders Respond to CMS “Patients Over Paperwork” RFI

More than 400 stakeholders responded to the federal government’s request for ideas to reduce the administrative burden associated with serving publicly insured patients. The request was disseminated via a Centers for Medicare & Medicaid Services request for information that was part of the agency’s “Patients over Paperwork” initiative. Among the groups that responded were the American Hospital Association, The American Association of Colleges of Nursing, the Critical Access Hospital Coalition, the Coalition of Long-Term Acute-Care Hospitals, the National Rural Association of Rural Health Clinics, the American Academy of Ophthalmology, the American Academy of Family Physicians, the American Hospital Association, and [...]

iqtsupport2019-08-16T10:27:17-04:00August 16, 2019|Centers for Medicare & Medicaid Services, Medicaid regulations, Medicare regulations|

Surprise Medical Billing Problem Growing Worse

Insured patients are getting more surprise medical bills, and more expensive surprise medical bills, even as Congress attempts to tackle this problem. According to a new study, 42.8 percent of emergency department patients now receive surprise medical bills for out-of-network services, up from 32.3 percent in 2010, with those surprise bills rising from a mean of $220 in 2010 to $628 in 2016. Patients experience similar frustrations with inpatient visits, with surprise bills for out-of-network services arriving in the mailboxes of 42 percent of patients in 2016, up from 26.3 percent in 2010. Those surprise bills rose from a mean [...]

iqtsupport2019-08-15T10:06:29-04:00August 15, 2019|Uncategorized|

New Public Charge Rule Could Affect Immigrants, Providers

Legal immigrants may become reluctant to seek government-sponsored health care and providers may find themselves delivering more uncompensated care in the wake of the adoption of a new federal “public charge” regulation that seeks to define more narrowly the kinds of individuals who should be granted entry to the U.S. in the future. The new Department of Homeland Security regulation, while focused on applicants for entry into the U.S., could have the unintended effect of discouraging legal immigrants from enrolling in Medicaid, CHIP, and other government programs and even lead them to disenroll from such programs out of a mistaken [...]

iqtsupport2019-08-14T09:26:39-04:00August 14, 2019|Uncategorized|

Can Medicare Feed its Way Out of Some Readmissions?

Feeding some Medicare patients after they are discharged from the hospital could reduce readmissions and save taxpayers millions, a new study has concluded. According to the new Bipartisan Policy Center report Next Steps in Chronic Care: Expanding Innovative Medicare Benefits, providing a limited number of free meals to certain Medicare patients could eliminate nearly 10,000 readmissions a year and save more than $57 million. Participating patients would be those with more than one of a limited number of chronic medical conditions and the meals would be for one week only. According to the report, more than 575,000 Medicare beneficiaries would [...]

iqtsupport2019-07-31T06:00:03-04:00July 31, 2019|Medicare|