HHS Office of the Inspector General

Federal Health Policy Update for November 9

The following is the latest health policy news from the federal government for November 3-9. Some of the language used below is taken directly from government documents. Congress Senate Finance Committee Earlier this week the Senate Finance Committee passed the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023. The bill, which passed out of the committee by a vote of 26-0, would: eliminate $16 billion in cuts to Medicaid DSH for 2024 and 2025; soften the 2024 cut to Medicare physician payments by reducing the conversion factor by 2.15 percent rather than the 3.4 percent that CMS [...]

iqtsupport2023-11-09T15:41:22-05:00November 9, 2023|340b, Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for October 26

The following is the latest health policy news from the federal government for October 20-26. Some of the language used below is taken directly from government documents. Congress More than three weeks after House Republicans voted Rep. Kevin McCarthy (CA) out of the speaker’s office, the House has elected Rep. Mike Johnson (LA) to the position. Speaker Johnson is a social conservative and has pushed for cuts to Medicare and Medicaid, including plans to roll back Medicaid expansion in 2019. The Speaker has said he intends for the House to take up as many FY 2024 spending bills as possible [...]

iqtsupport2023-10-26T15:51:16-04:00October 26, 2023|340b, Centers for Medicare & Medicaid Services, Congress, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for September 21

The following is the latest health policy news from the federal government for September 15 - 21. Some of the language used below is taken directly from government documents. Congress With only nine days left in the current federal fiscal year, Congress still has not agreed on any kind of spending bill to keep the federal government operating past September 30. If the federal government shuts down, the Department of Health and Human Services (HHS) will “use the full extent of the authority under the Antideficiency Act (ADA) to maintain existing HHS activities…” In previous shutdowns, Medicare has continued to [...]

iqtsupport2023-09-21T15:37:11-04:00September 21, 2023|Alternative payment models, Congress, COVID-19, Medicaid, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for September 7

The following is the latest health policy news from the federal government for September 1-7. Some of the language used below is taken directly from government documents. Congress House Republicans plan to introduce the Lower Cost, More Transparency Act for consideration before the end of the year. This bill includes provisions passed by three committees with health care jurisdiction: House Ways & Means, Energy & Commerce, and Education & Workforce. Some of the bill’s provisions would: eliminate scheduled Medicaid DSH cuts for FY 2024 and FY 2025; reauthorize and extend funding for the Community Health Center program, the National Health [...]

iqtsupport2023-09-07T16:39:42-04:00September 7, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|

Federal Health Policy Update for August 24

The following is the latest health policy news from the federal government for August 11-24. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services After suspending the No Surprises Act-created Independent Dispute Resolution process in the wake of a court ruling striking down a recent increase in fees for that process, CMS has established a new rate structure for initiating the adjudication of payment disagreements between providers and payers. It explains the new rate structure in this new FAQ, which nevertheless notes that despite the creation of new rates, the Independent [...]

Federal Health Policy Update for July 20

The following is the latest health policy news from the federal government for March 13-16. Some of the language used below is taken directly from government documents. Congress Senator Bernie Sanders (I-VT), chair of the Senate Health, Education, Labor and Pensions (HELP) Committee, has introduced a bill, the “Primary Care and Health Workforce Expansion Act.” The bill would: Increase funding for community health centers by $65 billion over five years, fund the National Health Service Corps at $8.3 billion over five years, and provide $250 million for HRSA coordination for the Women, Infants, and Children (WIC) program. Add 10,000 graduate [...]

iqtsupport2023-07-20T16:54:58-04:00July 20, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for May 11

The following is the latest health policy news from the federal government for May 5-11. Some of the language used below is taken directly from government documents. End of the COVID-19 Public Health Emergency DeBrunner & Associates has prepared a summary of the status of selected government health care waivers and flexibilities following expiration of the COVID-19 public health emergency today. The DeBrunner summary covers telehealth, COVID-19 treatment and coverage, flexible hospital operations, long-term-care hospitals, inpatient rehabilitation facilities and units, patient cost-sharing, and state Medicaid waivers. Find the summary here. CMS has sent a memo to state Medicaid and CHIP [...]

iqtsupport2023-05-11T14:13:44-04:00May 11, 2023|340b, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for March 3

The following is the latest health policy news from the federal government for February 27 to March 3. Some of the language used below is taken directly from government documents. No Surprises Act The Independent Dispute Resolution (IDR) entities empowered by the No Surprises Act to adjudicate disagreements between providers and payers may resume their work – but only some of it. CMS has directed IDRs entities to resume processing payment determinations on February 27 for disputes involving items or services furnished before October 25, 2022 but not to issue decisions involving items or services furnished on or after October [...]

iqtsupport2023-03-03T13:20:02-05:00March 3, 2023|Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, MedPAC, Telehealth|

Federal Health Policy Update for January 20

The following is the latest health policy news from the federal government for the week of January 13-20. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published updates to the Healthcare Common Procedure Coding System (HCPCS) codes on the Required Face-to-Face Encounter and Written Order Prior to Delivery List. The update adds ten codes to the list of items that require a face-to-face encounter between provider and patient and a written order prior to delivery as a condition of payment. Go here for a summary of the update [...]

iqtsupport2023-01-20T15:28:07-05:00January 20, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for December 8

The following is the latest health policy news from the federal government for the week of December 4-8. Some of the language used below is taken directly from government documents. No Surprises Act CMS has published an FAQ about implementation of good faith estimates for uninsured and self-pay patients under the No Surprises Act. In the FAQ the agency explains that it will extend enforcement discretion for situations in which good faith estimates do not include expected charges from co-providers or co-facilities. This enforcement discretion was expected to end on January 1 but CMS now writes that it will remain [...]

iqtsupport2022-12-08T17:09:11-05:00December 8, 2022|Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid regulations, Medicare, Medicare bad debt reimbursement, Medicare cuts, Medicare regulations, Medicare reimbursement policy, Telehealth|