Medicare Payment Advisory Commission

MedPAC Considers 2023 Medicare Rates at December Meeting

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 and debated: Assessing payment adequacy and updating payments: hospital inpatient and outpatient services and supporting Medicare safety-net hospitals – commissioners discussed a proposal to increase FY 2024 rates one percentage point more than current law prescribes.  Commissioners also discussed additional steps they might take to provide better support to safety-net hospitals, which they described as “…hospitals with high shares of low-income Medicare patients.” Status report: ambulatory surgical center services. Assessing payment [...]

Federal Health Policy Update for November 10

The following is the latest health policy news from the federal government for the week of November 7 to 10.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published a notice advising teaching hospitals that they have until November 18 to ask Medicare to reconsider their per resident amounts or resident caps as shown in the Hospital Cost Report Information System (HCRIS) associated with cost reports that, as of July 1, 2022, were not reopenable.  Learn more from this CMS notice. Due to an unplanned system outage of [...]

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 and debated: differences in quality measure results across Medicare populations policy options for increasing Medicare payments to primary care clinicians aligning fee-for-service payment rates across ambulatory settings mandated report: evaluation of a prototype design for a post-acute care prospective payment system supporting Medicare safety-net hospitals MedPAC is an independent congressional agency that advises Congress on issues involving Medicare.  While its recommendations are not binding on Congress or the administration, MedPAC is [...]

Federal Health Policy Update for October 27

The following is the latest health policy news from the federal government for the week of October  21 to October 27.  Some of the language used below is taken directly from government documents. 340B Responding to a federal court ruling that the federal government has shortchanged hospitals in its payments for 340B-covered prescription drugs, CMS has announced how it will compensate hospitals for its underpayments – at least for the 2023 fiscal year.  According to CMS, it “…will apply the default rate (generally ASP plus 6%) to 340B-acquired drugs for the rest of the year.  CMS also will reprocess claims [...]

FEDERAL HEALTH POLICY UPDATE FOR OCTOBER 20

The following is the latest health policy news from the federal government for the week of October 14 to October 20.  Some of the language used below is taken directly from government documents. White House President Biden has signed an executive order on lowering prescription drug costs.  The order directs HHS to consider additional actions to further drive down prescription drug costs, encourages it to pursue such actions through its Center for Medicare and Medicaid Innovation (CMMI), and directs HHS to submit a formal report within 90 days outlining any plans to use CMMI’s authority to lower drug costs and [...]

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 [...]

Federal Health Policy Update for October 6

The following is the latest health policy news from the federal government for the week of September 26 to October 6.  Some of the language used below is taken directly from government documents. 340B HHS must immediately end its significant cut in reimbursement for 340B-covered prescription drugs provided on an outpatient basis to eligible patients, a federal court has ruled, writing that “The prospective portion of the 2022 reimbursement rate shall be vacated because it is defective and because vacating this portion of the 2022 OPPS Rule will not cause substantial disruption” and that “HHS should not be allowed to [...]

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 the Week of August 24 to September 2

The following is the latest health policy news from the federal government for the week of August 29 to September 2.  Some of the language used below is taken directly from government documents. The White House The White House has introduced a new “National HIV Strategy” for 2022-2025.  The new strategy updates the 2021 strategy and establishes targets for ending the HIV epidemic in the U.S. by 2030, including a 75 percent reduction in new HIV infections by 2025 and a 90 percent reduction by 2030.  Find the strategy here. Proposed Changes in Medicaid, CHIP, and Basic Health Program Enrollment [...]

Federal Health Policy Update for Tuesday, August 23

The following is the latest health policy news from the federal government as of 2:45 p.m. on Tuesday, August 23.  Some of the language used below is taken directly from government documents. CMS “Roadmap for the End of the COVID-19 Public Health Emergency” While the COVID-19 public health emergency (PHE) has not ended and HHS Secretary Becerra has committed to giving states and the health care community 60 days’ notice before formally ending it – notice he has not given – the federal government is already planning for life after the PHE and its latest step in this process is [...]

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