Medicare Advantage

LTCH Numbers in Free Fall

The number of long-term care hospitals in the U.S. is falling fast. According to hospital industry sources, more than a quarter of all long-term care hospitals – commonly referred to as LTCHs – have closed over the past decade. Among the reasons for all the closings, according to those same sources, are low Medicare payments; Medicare site-neutral payment policies that limit the kinds of patients for which LTCHs can receive full, LTCH-level payments and not lower reimbursement; and the refusal of some Medicare Advantage plans to include LTCHs in their provider networks. LTCHs traditionally provide acute-care services to patients who [...]

joe2026-04-28T15:25:40-04:00April 29, 2026|hospitals, Medicare reimbursement policy, Uncategorized|

Federal Health Policy Update for April 16

The following is the latest health policy news from the federal government for April 11-16. Some of the language used below is taken directly from government documents. CMS – New Proposed Regulations FY 2027 Medicare Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System Proposed Rule CMS has published its proposed FY 2027 Medicare hospital inpatient and long-term-care hospital prospective payment system rule. The highlights of the proposed rule are: A 2.4 percent rate increase for both acute-care hospital inpatient and long-term care hospital services. A $564 million reduction in Medicare disproportionate share hospital (Medicare DSH) and [...]

joe2026-04-16T16:21:07-04:00April 16, 2026|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

MedPAC Meets

MedPAC’s commissioners held their latest public meeting on Thursday, April 9 and Friday, April 11. The subjects on the meeting’s agenda were: improving payment incentives in Medicare analysis of regional benchmarks and benchmark-plan availability in the Part D prescription drug plan market preferred networks and pharmacy access in Part D estimated association between Medicare Advantage enrollment and hospitals’ and post-acute care providers’ finances information sources that beneficiaries use to make Medicare enrollment decisions institutional special-needs plans: provision of services, network-adequacy requirements, and star ratings mandated report: assessment of the Medicare ground ambulance data collection system Go here for summaries of [...]

joe2026-04-15T08:18:40-04:00April 15, 2026|Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for April 10

The following is the latest health policy news from the federal government for April 4-10. Some of the language used below is taken directly from government documents. Congress The House and Senate were in recess this week and are scheduled to be back in session on April 14. House Speaker Mike Johnson (R-LA) has indicated that the House will not vote on the Senate‑passed Department of Homeland Security continuing resolution until there is meaningful progress on a reconciliation package to fund U.S. Immigration and Customs Enforcement (ICE) and U.S. Customs and Border Protection. In an effort to narrow the scope [...]

joe2026-04-10T13:43:20-04:00April 10, 2026|340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy|

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|