Medicare Advantage

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 Friday, March 10

The following is the latest health policy news from the federal government for March 6-10. Some of the language used below is taken directly from government documents. White House FY 2024 Budget Proposal The Biden administration this week released its proposed FY 2024 federal budget. Among its many proposals are measures to extend the life of the Medicare hospital trust fund and reduce Medicare beneficiaries’ health care costs; to reduce prescription drug costs for consumers, Medicare, and Medicaid; to return high Medicaid managed care organization profits to the federal government; to make behavioral health care more affordable for seniors; to [...]

iqtsupport2023-03-10T15:57:42-05:00March 10, 2023|340b, Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

MedPAC Meets

The government agency that advises Congress on Medicare payment matters met publicly in Washington, D.C. last week. During the virtual meeting, members of the Medicare Payment Advisory Commission discussed: reforming Medicare’s wage index system addressing the high prices of drugs covered under Medicare Part B a prototype design for a post-acute care prospective payment system favorable selection and future directions for Medicare Advantage payment policy aligning fee-for-service payment rates across ambulatory care settings MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are not binding on either Congress or the administration, MedPAC is [...]

iqtsupport2023-03-09T13:00:37-05:00March 9, 2023|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, post-acute care|

Federal Health Policy Update for February 6

The following is the latest health policy news from the federal government for the week of January 23 to February 6. Some of the language used below is taken directly from government documents. 340B Pharmaceutical companies may restrict the ability of providers to use specialty and community pharmacies to distribute 340B-covered drugs, a federal appeals court has decided. See the court’s ruling here. Centers for Medicare & Medicaid Services CMS has revised its fact sheets about COVID-19 public health emergency waivers and flexibilities for different types of providers, updating which waivers and flexibilities have already been terminated, which have been [...]

iqtsupport2023-02-06T17:03:31-05:00February 6, 2023|340b, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15. Some of the language used below is taken directly from government documents. White House The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans. Learn more about the plan from this White House fact sheet and go here for a transcript of the White House [...]

FEDERAL HEALTH POLICY UPDATE FOR OCTOBER 13

The following is the latest health policy news from the federal government for the week of October 7 to October 13. Some of the language used below is taken directly from government documents. Public Health Emergency Declaration HHS Secretary Becerra has renewed the COVID-19 Public Health Emergency declaration. This renewal does not provide the promised 60-day notice of the PHE’s end, so for now, the current declaration is set expire on January 11, 2023. We will continue to update you on any changes to the PHE timeline. You can view the PHE renewal here. White House The White House COVID-19 [...]

iqtsupport2022-10-13T17:14:18-04:00October 13, 2022|Centers for Medicare & Medicaid Services, COVID-19, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|

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 [...]

iqtsupport2022-09-08T06:00:28-04:00September 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. [...]

iqtsupport2022-06-30T17:01:01-04:00June 30, 2022|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations for long-term care, Medicare, Medicare post-acute care, Medicare regulations, MedPAC|

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 [...]

iqtsupport2022-04-07T17:12:01-04:00April 7, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

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 [...]

iqtsupport2022-02-03T17:46:52-05:00February 3, 2022|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|