Medicaid

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 [...]

Inadequate Data Hinders Federal Approach to Health Equity

Federal efforts to develop and improve payment models and other programs designed to foster health equity are often hamstrung by poor data: inconsistent data requests from program to program and flawed and incomplete data reporting by those participating in those programs. As a result, federal policymakers often are unable to tell whether programs – both those developed specifically to address health equity and those that are not – are having the desired effect on health equity. The result, according to a new study from the Centers for Medicare & Medicaid Services’ Center for Medicare and Medicaid Innovation, is that 1) [...]

iqtsupport2023-07-19T10:50:34-04:00July 19, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity|

Federal Health Policy Update for May 25

The following is the latest health policy news from the federal government for May 19-25. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Committee has advanced to the full House two bills with significant implications for health care providers. H.R. 3561 calls for delaying $8 billion a year in Medicaid DSH cuts for two years – cuts scheduled to take effect in October; imposing site-neutral payments for drug infusion services provided in off-campus hospital outpatient departments; imposing stronger price transparency requirements on hospitals; and requiring hospitals to report selected ownership [...]

iqtsupport2023-05-25T15:37:35-04:00May 25, 2023|340b, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations, Telehealth|

Federal Health Policy Update for May 18

The following is the latest health policy news from the federal government for May 12-18. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Health Subcommittee has approved and advanced five bipartisan health care bills. H.R. 3281 combined a number of proposals into a larger package and includes provisions that would: delay for two years Medicaid disproportionate share (Medicaid DSH) cuts currently scheduled to take effect on October 1; require health providers to use a unique identifier for each off-campus or remote outpatient department beginning in 2026; change how Medicare pays [...]

iqtsupport2023-05-18T17:13:49-04:00May 18, 2023|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicare, 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|

The Emergence of “Food as Medicine”

In both the public and private sectors, a growing movement is working to integrate food as part of medical treatment – and have health care payers foot the bill. From the administration’s granting of Medicaid waivers to Arkansas, Massachusetts, and Oregon to use state and federal money to pay for food for some beneficiaries to Congress tucking $2 million into an appropriations bill for a “food is medicine pilot program” to the NIH developing a $140 million grant program that will lead to the designation of “food is medicine centers of excellence,” providers and policy-makers are showing unprecedented interest in [...]

iqtsupport2023-02-27T06:00:08-05:00February 27, 2023|health equity, Medicaid, Medicare, social determinants of health|

Results of Annual Survey of State Medicaid Programs

The Kaiser Family Foundation has published the results of its annual survey of state Medicaid programs for the 2022 and 2023 fiscal years. Among the survey’s findings (in language taken directly from the Kaiser report): More than 3/4 of states that contract with MCOs [managed care organizations] enroll ≥75% of all beneficiaries in MCOs Some states reported newly implementing or expanding MCO programs States also report continued use of other service delivery and payment system reforms Two-thirds of states are using strategies to improve race, ethnicity, and language data About one-quarter of states are tying MCO financial incentives to health [...]

iqtsupport2022-10-27T06:00:07-04:00October 27, 2022|COVID-19, Medicaid, Medicaid long-term services and supports, Medicaid managed care, social determinants of health, Telehealth|

New Health Care Leaders Share Priorities

New leaders at the Centers for Medicare & Medicaid Services and the Center for Medicare and Medicaid Innovation are quickly making their priorities known to health care industry stakeholders. For new CMS administrator Chiquita Brooks-LaSure, her priority is coverage. She has declared that “Our focus is going to be on making sure regulations and policies are going to be focused on improving coverage,” and while she hopes that states that have not yet expanded their Medicaid programs will take advantage of current federal incentives to do so, there is another path to coverage: “…the public option or other coverage certainly [...]

iqtsupport2021-06-10T06:00:44-04:00June 10, 2021|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Medicaid|

Medicare Beneficiaries Happier With Their Health Insurance Than Privately Insured

People who are enrolled in Medicare are happier with their health insurance than those with private health insurance, according to a recent JAMA report. Researchers found that the privately insured had a more difficult time finding doctors, were less likely to have a personal physician, had to deal with higher medical costs, were more likely to have medical debt, were more likely not to fill prescriptions because of their cost, and were less satisfied with their care than people insured by Medicare. The findings were true whether people purchased their own health insurance or had employer-sponsored insurance. Learn more about [...]

iqtsupport2021-06-03T06:00:26-04:00June 3, 2021|Medicaid, Medicare|

GAO Looks at “Medicaid in Times of Crisis”

The federal government often turns to Medicaid to address problems, mitigate damage, and serve vulnerable populations, especially in times of crisis. In a new issue brief, the U.S. Government Accountability Office looks at examples of how states and the federal government have turned to Medicaid in times of crisis and some of the policy considerations underlying those actions. Find these examples in the new GAO report “Medicaid in Times of Crisis.”

iqtsupport2021-02-24T13:00:53-05:00February 24, 2021|Medicaid|