Medicare Advantage

MedPAC Submits March Report to Congress

As required by law, the Medicare Payment Advisory Commission has submitted its March report to Congress. In this year’s report, MedPAC: evaluates the adequacy of Medicare’s fee-for-service payments and offers its recommendation for changes in the coming year; offers its perspectives on the Medicare Advantage program (Medicare Part C) and the Medicare prescription drug program (Medicare Part D); describes trends and key issues in post-acute care and offers a status report on ambulatory surgical centers; and submits reports mandated by Congress on the performance of special-needs plans for dually eligible (Medicare and Medicaid) beneficiaries and on how changes in the [...]

joe2026-03-12T17:26:14-04:00March 17, 2026|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for March 12

The following is the latest health policy news from the federal government for March 6-12. Some of the language used below is taken directly from government documents. Congress While the House was in recess this week, the Republican caucus held its annual retreat to discuss legislative priorities. Speaker Mike Johnson (R-LA) continues to push for another reconciliation bill, hoping to revisit several proposals to reduce Medicaid spending that were not included in HR another rank-and-file Republicans have expressed doubt that this will be possible. Both chambers of Congress are scheduled to be in session next week. The House Committee on [...]

joe2026-03-12T16:09:44-04:00March 12, 2026|Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicare, Medicare post-acute care, Medicare reimbursement policy|

MedPAC Posts Agenda for March 2-3 Meeting

The Medicare Payment Advisory Commission has posted the agenda for its next public meeting, which will be held on Monday, March 2 and Tuesday, March 3. The subjects scheduled for consideration during MedPAC’s next two-day session are: mandated report: Assessment of the Medicare ground ambulance data collection system access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease and beneficiaries with cancer provider participation in Medicare Advantage networks considerations for implementing Medicare Advantage encounter data in risk adjustment the complexity of Medicare enrollment decisions for beneficiaries Medicare Part B premium payment basics Go here to see [...]

joe2026-02-26T16:20:05-05:00February 27, 2026|Medicare, Medicare reimbursement policy|

Medicare Advantage Musical Chairs Continues

Even as the number of seniors enrolling in Medicare Advantage plans rises every year, the program’s stability is threatened by the withdrawal of those plans from the program. According to a new JAMA Network analysis, after years of just one percent of Medicare Advantage participants being forced to find new plans because their plan left the program, the rate of participants who need to find new plans for that reason rose to 6.5 percent in 2025 and to ten percent in 2026. This is occurring, moreover, even though the number of plans participating in Medicare Advantage continues to increase. The [...]

joe2026-02-24T14:21:56-05:00February 24, 2026|Medicare|

Federal Health Policy Update for February 5

The following is the latest health policy news from the federal government for January 30 through February 5. Some of the language used below is taken directly from government documents. Congress On Tuesday Congress passed, and the president immediately signed, a package of appropriations bills that, among other government operations, funded the Department of Health and Human Services for the rest of federal FY 2026. Major provisions include: The extension of telehealth flexibilities through the end of 2027. The elimination of $8 billion cuts in Medicaid disproportionate share (Medicaid DSH) allotments to the states for both FY 2026 and FY [...]

Federal Health Policy Update for January 22

The following is the latest health policy news from the federal government for January 16-22. Some of the language used below is taken directly from government documents. Congress The House today passed an Appropriations Committee FY 2026 partial spending proposal that includes a Labor, Health and Human Services, Education, and Related Agencies bill. Policy highlights include: Telehealth. The bill would extend the major Medicare telehealth flexibilities and the waiver of periodic in-person visits for mental health telehealth services through the end of 2027. Medicaid DSH. The bill would cancel the FY 2026 and FY 2027 cuts of $8 billion a year and leave just one year, [...]

joe2026-01-22T17:37:45-05:00January 22, 2026|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|

MedPAC Meets

MedPAC’s commissioners held their latest public meeting on Thursday, January 15 and Friday, January 16. The primary subject of the meeting was discussion of MedPAC’s preliminary recommendations for Medicare rates for 2027. The topics on the meeting’s agenda were: Medicare payments for hospital inpatient and outpatient services Medicare payments for physicians and other health professional services Medicare payments for skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis, and hospice services mandated reports on dual-eligible special-needs plans and the impact of recent changes in the home health prospective payment system status reports on the Medicare [...]

joe2026-01-21T12:01:24-05:00January 21, 2026|Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for January 8

The following is the latest health policy news from the federal government for December 29 to January 8. Some of the language used below is taken directly from government documents. Congress Congress returned from winter recess facing a full policy agenda and health care issues remain prominent. Following the expiration of the Affordable Care Act’s enhanced premium tax credits, the House is expected to vote on a three-year clean extension brought by a discharge petition from Democratic House Leader Hakeem Jefferies (D-NY). The Senate is unlikely to advance the measure but a bipartisan group of senators is developing an alternative: [...]

joe2026-01-08T15:32:32-05:00January 8, 2026|340b, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for December 18

The following is the latest health policy news from the federal government for December 12-18. Some of the language used below is taken directly from government documents. Congress In a 216-211 vote yesterday, the House passed the Lower Health Care Premiums for All Americans Act, a Republican package aimed at addressing multiple health care policies. The legislation includes provisions for employee tax-advantaged benefits like HSAs and FSAs, cost-sharing reductions (CSR) subsidies, and increased transparency requirements for pharmacy benefit managers (PBMs). It notably did not include an extension of the enhanced Affordable Care Act premium tax credits that many of the [...]

joe2025-12-18T16:29:43-05:00December 18, 2025|Accountable Care Organization, ACO, Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for December 4

The following is the latest health policy news from the federal government for November 21 through December 4. Some of the language used below is taken directly from government documents. Congress Congress is back in session to discuss the Affordable Care Act tax credits set to end on December 31and other extenders that will expire on January 30, 2026 along with the latest continuing resolution (CR). Members continue to negotiate potential solutions to the expiring enhanced Affordable Care Act premium subsidies but there is no consensus on whether or how to address the expiring benefit. Senate Majority Leader Thune (R-SD) [...]

joe2025-12-04T15:05:28-05:00December 4, 2025|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|