Medicare Advantage

MedPAC Meets

The Medicare Payment Advisory Commission held public meetings on September 1 and 2.  Among the subjects discussed during the meeting were: Reforming Medicare’s wage index system – “the commission remains concerned about Medicare’s current wage index policies, including the system’s inaccuracy, the circularity of hospital-reported data, the large volume of permitted exceptions, and administrative complexity and MedPAC commissioners discussed an alternative wage index methodology.” Context for Medicare payment policy – an annual discussion. Standardizing benefits in Medicare Advantage plans – cost sharing for Part A and Part B services Medicare Advantage encounter data – “MedPAC has been concerned about the [...]

2022-09-08T06:00:28-04:00September 8, 2022|Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for Thursday, June 30

The following is the latest health policy news from the federal government as of 2:45 p.m. on Thursday, June 30.  Some of the language used below is taken directly from government documents. White House The White House has unveiled its “White House Blueprint for Addressing the Maternal Health Crisis.” Monkeypox Update The White House has announced the first phase of its national monkeypox vaccine strategy, a part of its monkeypox outbreak response.  The major components of the strategy include expanded efforts to vaccinate those most at risk, expanded testing supply and availability, and greater engagement with community leaders and stakeholders.  [...]

Federal Health Policy Update for Thursday, April 7

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, April 7.  Some of the language used below is taken directly from government documents. White House The administration is proposing to address a flaw in the Affordable Care Act often referred to as the “family glitch.”  Under the ACA, people who do not have access to “affordable” health insurance through their jobs may qualify for a premium tax credit to purchase coverage on the ACA’s health insurance marketplaces. Current regulations define employer-based health insurance as “affordable” if the coverage for the employee [...]

Federal Health Policy Update for Thursday, February 3

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, February 3.  Some of the language used below is taken directly from government documents. Provider Relief Fund The reconsideration window for Provider Relief Fund Phase 4 payments and American Rescue Plan rural hospital payments is now open for providers to request reconsideration of their payments.  This process is intended only for providers that believe their payment was not calculated correctly.  They will not have an opportunity to submit an application if they missed a deadline; will not be able to revise or [...]

Federal Health Policy Update for Tuesday, January 11

The following is the latest health policy news from the federal government as of 2:30 p.m. on Tuesday, January 11.  Some of the language used below is taken directly from government documents. Provider Relief Fund HHS has updated its FAQ for reconsideration requests involving Phase 4 and rural hospital payments.  Find the updated FAQ here. Department of Health and Human Services COVID-19 HHS announced that beginning January 15, individuals with private health insurance coverage who purchase an over-the-counter COVID-19 diagnostic test authorized, cleared, or approved by the FDA will be able to have those test costs covered by their insurance.  [...]

MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week to discuss various Medicare payment issues. Among the issues discussed at MedPAC’s March meeting were: Medicare beneficiary access to care in rural areas skilled nursing facility value-based purchasing program and proposed replacement streamlining CMS’s portfolio of alternative payment models balancing efficiency with equity in Medicare Advantage benchmark policy relationship between clinician services and other Medicare services revising Medicare’s indirect medical education payments to better reflect teaching hospitals’ costs Medicare’s vaccine coverage and payment separately payable drugs in the hospital outpatient prospective payment system MedPAC is an independent congressional agency [...]

2021-03-10T06:00:08-05:00March 10, 2021|Medicare, MedPAC|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s March agenda were: Addressing Medicare Shared Savings Program vulnerabilities The role of specialists in alternative payment models and accountable care organizations Realigning incentives in Medicare Part D Redesigning the Medicare Advantage quality bonus program Mandated report: Impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees Improving Medicare’s end-stage renal disease prospective payment system Separately payable drugs in the hospital outpatient prospective payment system MedPAC is an independent congressional agency that advises [...]

MedPAC Meeting Transcript Now Available

Last week the Medicare Payment Advisory Commission met in Washington, D.C.  The Medicare payment issues on its agenda were: Assessing payment adequacy and updating payments: Physician and other health professional services Assessing payment adequacy and updating payments: Ambulatory surgical center services Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; Mandated report: Expanding the post-acute care transfer policy to hospice Assessing payment adequacy and updating payments: Skilled nursing facility services Assessing payment adequacy and updating payments: Home health care services Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services Assessing payment adequacy and updating payments: Long-term care [...]

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s December agenda were: Assessing payment adequacy and updating payments: Physician and other health professional services Assessing payment adequacy and updating payments: Ambulatory surgical center services Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; Mandated report: Expanding the post-acute care transfer policy to hospice Assessing payment adequacy and updating payments: Skilled nursing facility services Assessing payment adequacy and updating payments: Home health care services Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services Assessing payment [...]

MedPAC to Meet Tomorrow

The Medicare Payment Advisory Commission meets this Thursday and Friday in Washington, D.C. MedPAC’s December agenda is dominated by Medicare payment issues:  how much Medicare should pay for different types of services in calendar year 2021 and FY 2021.  The services to be addressed during the December 5-6 meetings are physician and other health professional services, ambulatory surgical center services, hospital inpatient and outpatient services, skilling nursing facility services, home health services, inpatient rehabilitation facility services, long-term care hospital services, outpatient dialysis services, and hospice services. In addition, MedPAC commissioners will discuss their mandated report on expanding Medicare’s post-acute care [...]

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