Medicaid state directed payments

Hospitals Chart 2025 Public Policy Objectives

The hospital industry has an ambitious public policy agenda for 2025 – most of it involving defending the status quo against proposed changes. Hospitals’ advocacy in 2025 will focus on: Fighting off Medicaid cuts, work requirements, reductions in the federal Medicaid matching rate, eliminating scheduled cuts in Medicaid disproportionate share (Medicaid DSH) allotments to the states, and protecting state-directed Medicaid payments and the ability of states to raise Medicaid funding through provider taxes. Preventing a transition to site-neutral payments for Medicare-covered outpatient services. Ensuring the continuation of current section 340B prescription drug discount program practices. Preserving and even extending current [...]

joe2025-02-12T11:11:23-05:00February 13, 2025|340b, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy, Telehealth|

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 [...]

iqtsupport2023-07-05T13:34:25-04:00July 5, 2023|Centers for Medicare & Medicaid Services, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care|

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 [...]

iqtsupport2023-06-29T15:36:39-04:00June 29, 2023|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare reimbursement policy|