Medicaid and CHIP Payment and Access Commission

Federal Health Policy Update for September 28

The following is the latest health policy news from the federal government for September 22-28.  Some of the language used below is taken directly from government documents. The White House President Biden has signed H.R. 2544, the Securing the U.S. Organ Procurement and Transplantation Network Act,  which provides for awarding multiple grants, contracts, or cooperative agreements to operate the Organ Procurement and Transplantation Network. Congress Congressional leaders have not come to agreement on how to avert a federal government shutdown this weekend.  While Senate leaders introduced a continuing resolution that would fund the government through November 17, that bill has [...]

Federal Health Policy Update for July 28

The following is the latest health policy news from the federal government for July 21 -28.  Some of the language used below is taken directly from government documents. Medicare Payment Regulations CMS has published a final rule to update Medicare payment policies and rates under its inpatient rehabilitation facility (IRF) prospective payment system and IRF quality reporting program for FY 2024.  The final rule includes a 3.4 percent rate increase and changes in the outlier threshold, the case-mix-group relative weights and average length of stay values, and the wage index.  In addition, this rule rebases and revises the IRF market [...]

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 [...]

MACPAC Looks at Medicaid State Directed Payments

In 2016, the Centers for Medicare & Medicaid Services authorized states to direct Medicaid managed care organizations to pay providers according to specific rates or methods.  Typically, states use these arrangements, often referred to as state directed payments, to establish minimum payments for certain types of providers or to require participation in value-based payment arrangements.  A few states, though, use state directed payments to require Medicaid managed care organizations to make large, additional payments to providers similar to supplemental payments their Medicaid fee-for-service programs. In a new issue brief, the Medicaid and CHIP Payment and Access Commission describes the history [...]

Federal Health Policy Update for June 29

The following is the latest health policy news from the federal government for June 23-29.  Some of the language used below is taken directly from government documents. The White House President Biden has issued an executive order on strengthening access to affordable contraception and family planning services for women with private health insurance and through Medicaid, Medicare, and federally supported health programs and to foster research on access.  Learn more from this White House fact sheet and the administration’s executive order.   Department of Health and Human Services HHS’s Office of the Inspector General (OIG) has posted its final rule [...]

MACPAC Proposes New Approach to Helping Safety-Net Hospitals

To improve “…the relationship between total state and federal DSH [Medicaid disproportionate share] funding and the number of non-elderly low-income individuals in a state,” the Medicaid and CHIP Payment and Access Commission has urged Congress to direct the Department of Health and Human Services to change how it calculates Medicaid DSH allotments to the states. This year MACPAC devotes a significant portion of its annual report to Congress to payment policy for safety-net hospitals, and in summarizing its proposal it writes that: In order to reduce the wide variation in state disproportionate share hospital (DSH) allotments based on historical spending, [...]

Federal Health Policy Update for June 22

The following is the latest health policy news from the federal government for June 9-22.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced new flexibilities to help keep Americans insured as states resume Medicaid and Children’s Health Insurance Program (CHIP) renewals.  The new flexibilities were announced in a letter sent by HHS Secretary Xavier Becerra to the nation’s governors urging them to adopt all available flexibilities to minimize avoidable coverage losses among children and families.  The new flexibilities include permitting managed care plans to assist people currently [...]

Federal Health Policy Update for May 4

The following is the latest health policy news from the federal government for April 28 – May 4.  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 upon the expiration of the COVID-19 public health emergency on May 11. 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. The COVID-19 public health [...]

Federal Health Policy Update for April 20

The following is the latest health policy news from the federal government for April 8 – 20.  Some of the language used below is taken directly from government documents. The White House The Biden administration has announced a plan to expand health coverage for Deferred Action for Childhood Arrivals (DACA) individuals.  To this end, it announced that HHS will soon propose a rule amending the definition of “lawful presence,” for purposes of Medicaid and Affordable Care Act coverage, to include DACA recipients.  If finalized, the rule would make DACA individuals eligible for these programs for the first time.  Under the proposed rule, [...]

Federal Health Policy Update for March 30

The following is the latest health policy news from the federal government for March 24-30.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS’s Center for Medicare and Medicaid Innovation (CMMI) has extended its Medicare Advantage Value-Based Insurance Design (VBID) Model for calendar years 2025 through 2030 and will introduce changes intended to address more fully the health-related social needs of patients, advance health equity, and improve care for patients with serious illness.  Learn more from this CMS announcement, which includes a link to additional information about the program. CMS [...]

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