Medicare Part D

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 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 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|

Federal Health Policy Update for June 12

The following is the latest health policy news from the federal government for June 6-12. Some of the language used below is taken directly from government documents. Congress Republican senators continue to work on their version of a reconciliation bill with a goal of passage by July 4, although that deadline may slip. Some Senate committees have begun releasing their portions of the bill but the Finance Committee’s bill, with its tax and Medicaid provisions, has not yet been released. Among the majority party in the Senate, fault lines around the House-passed reconciliation bill remain around Medicaid provider taxes, state [...]

joe2025-06-12T16:32:26-04:00June 12, 2025|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

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 today passed the budget resolution passed by the Senate last week. Passage of the same budget resolution by both chambers now enables Congress to begin work on a reconciliation bill to enact President Trump’s priorities on tax cuts, border security, and energy policies. Until this morning, more than a dozen Republican House members had opposed the Senate-passed budget resolution because they believed the Senate’s budget did not require enough spending [...]

joe2025-04-10T16:05:02-04:00April 10, 2025|Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for January 23

The Administration Public Communication The new administration has directed HHS to pause all external communications, including announcements, advisories, regular publications, and web site updates. According to a published report, "HHS has issued a pause on mass communications and public appearances that are not directly related to emergencies or critical to preserving health," a spokesperson wrote in an email. "This is a short pause to allow the new team to set up a process for review and prioritization. There are exceptions for announcements that HHS divisions believe are mission critical, but they will be made on a case-by-case basis." The directive [...]

MedPAC Meets

MedPAC’s commissioners held their latest public meetings on Thursday, January 13 and Friday, January 14. The subjects on the meetings’ agenda were: assessing payment adequacy and updating payments: physician and other health professional services assessing payment adequacy and updating payments: hospital inpatient and outpatient services assessing payment adequacy and updating payments: skilled nursing facility services; home health agency services; inpatient rehabilitation facility services; outpatient dialysis services; and hospice services eliminating Medicare’s coverage limits on stays in freestanding inpatient psychiatric facilities Medicare prescription drug program (Part D): status report ambulatory surgical center services: status report the Medicare Advantage program: status report [...]

joe2025-01-21T17:23:04-05:00January 22, 2025|Centers for Medicare & Medicaid Services, Federal Update, hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for January 16

The following is the latest health policy news from the federal government for January 11-17. Some of the language used below is taken directly from government documents. Congress House Budget Committee Republican members of the House Budget Committee have circulated a list of possible policy changes that would reduce federal spending by between $5.3 trillion and $5.7 trillion over a period of ten years. Up to $3.4 trillion of those possible cuts could include reductions in federal health care spending. The health care cuts the document lists (all figures are ten-year reductions) are: Medicare introducing Medicare site-neutral outpatient payments - [...]

Federal Health Policy Update for December 5

The following is the latest health policy news from the federal government for November 22 – December 5. Some of the language used below is taken directly from government documents. Congress The House has posted its session calendar for 2025. Find that calendar here. Yesterday, House Republicans made an offer to House Democrats regarding health care provisions to be included in the continuing resolution (CR) that must pass before December 20. The offer is a conversation-opener and very few details are available. Although most of the proposed policies have bipartisan support, there are some tangible policy differences, including House Democrats’ [...]

joe2024-12-05T17:14:33-05:00December 5, 2024|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Federal Update, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Pennsylvania Update|