Medicare physician payments

Federal Health Policy Update for December 19

The following is the latest health policy news from the federal government for December 13-19. Some of the language used below is taken directly from government documents. Congress Funding for the operation of the federal government will expire tomorrow, December 20, unless Congress passes a funding bill. Earlier this week, congressional leaders agreed on a continuing resolution that included a number of health care priorities, including relief from scheduled Medicaid DSH cuts, relief for Medicare physician payment cuts, extension of telehealth flexibilities, extension of the Acute Hospital Care at Home program, a number of changes in the practices of pharmacy [...]

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|

Looking Ahead to Lame Duck

When the dust clears after next week’s presidential election, Congress will return to Washington with numerous unfinished matters on its agenda – including many with implications for health care organizations. They include: Federal government funding, authorization for which expires on December 20. Medicare payments to physicians, which many in Congress want to increase if, as proposed, the Centers for Medicare & Medicaid Services reduces those payments for 2025. A potential temporary extension of the continued use of telehealth to prescribe Schedule 2 drugs such as Adderall. Payment adjustments for low-volume and Medicare-dependent hospitals. Renewal of authorization for the COVID-era Acute [...]

joe2024-10-30T17:22:55-04:00October 31, 2024|COVID-19, hospitals, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare cuts, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for May 30

The following is the latest health policy news from the federal government for May 24-30. Some of the language used below is taken directly from government documents. Congress When the House and Senate return to Washington, DC from the Memorial Day recess next week committees will resume holding hearings and markups on health care policy while appropriators will focus on funding for federal fiscal year 2025, which begins October 1. While there seems to be plenty of activity in Congress it is widely expected that only the most essential bills, like emergency supplemental packages and bills to keep the federal [...]

joe2024-05-30T21:29:22-04:00May 30, 2024|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, hospitals, Medicaid, Medicaid managed care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Medicaid DSH Cut In, Medicare Site-Neutral Payments Out of Health Bill?

With Congress at a stalemate on spending legislation, lawmakers are considering a narrower scope of issues to address in near-term health care legislation. According to published reports, scheduled cuts in Medicaid disproportionate share allotments to states (Medicaid DSH), already delayed several times, could be delayed once again. In addition, a proposal to require Medicare to pay for outpatient services on a site-neutral basis, rather than paying higher rates to hospital-based outpatient departments higher rates, might not be included. Also under consideration: restoring some cuts in Medicare’s payments to physicians and additional funding for community health centers. Also in jeopardy at [...]

joe2024-02-27T18:53:55-05:00February 28, 2024|Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare cuts, Medicare reimbursement policy|

MedPAC Offers FY 2024 Rate Recommendations

Medicare rates would rise for some providers and fall for others based on recommendations made to Congress last week by the Medicare Payment Advisory Commission, the independent congressional agency that advises Congress on Medicare reimbursement matters. MedPAC’s rate recommendations to Congress and the administration, which it approved at its January 2023 meeting, are: Outpatient and inpatient prospective payment systems – under current law, the estimated increase would be about 2.9 percent; MedPAC proposes 2.9 percent plus one percent. Physician services – increase fees 50 percent of the projected increase in the medical economic index (MEI). Skilled nursing facilities – reduce [...]

iqtsupport2023-03-22T06:00:32-04:00March 22, 2023|Congress, hospitals, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for December 22

The following is the latest health policy news from the federal government for the week of December 19-22. Some of the language used below is taken directly from government documents. Congress As of this writing, Congress continues to work on an FY 2023 omnibus spending bill: the Senate has passed it but the House has not yet addressed it. Highlights of what negotiators have agreed to – but that have not yet been adopted – include: Preventing the additional four percent Medicare sequester for two years. Reducing by more than half the 4.5 percent cut in Medicare payments to physicians [...]

iqtsupport2022-12-22T17:30:38-05:00December 22, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, hospitals, Medicaid, Medicare, Medicare bad debt reimbursement, Medicare regulations, Medicare reimbursement policy, Telehealth|

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 [...]

iqtsupport2022-12-14T06:00:43-05:00December 14, 2022|Congress, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

117th Congress’s Waning Hours

In addition to its biggest challenge – funding the federal government, authorization for which ends on December 16 – Congress has a number of health care issues on its agenda that at least some lawmakers and health care industry stakeholders would like to see it address before the year ends. Those issues include the cut in Medicare payments to physicians scheduled to take place on January 1; the desire of many to make permanent some of the flexibilities to use telehealth that were temporarily authorized in response to the COVID-19 public health emergency; additional pandemic funding for new vaccines, new [...]

iqtsupport2022-11-17T06:00:49-05:00November 17, 2022|Congress, COVID-19, Medicare, Medicare reimbursement policy, Telehealth|

MedPAC Makes 2023 Medicare Payment Recommendations

The Medicare Payment Advisory Commission has released its March 2022 Report to the Congress: Medicare Payment Policy. The report includes MedPAC’s recommendations for Medicare payments in 2023. For the coming year, MedPAC recommends the following changes in Medicare fee-for-service payments: hospital inpatient payments – increase 2.5% hospital outpatient payments – increase 2.0% long-term care hospital payments – increase approximately 2.0% outpatient dialysis payments – increase 1.2% physician, ambulatory surgical center, and hospice payments – no change skilled nursing facility, home health, and inpatient rehabilitation facility payments – reduce 5.0% The report also reviews the status of Medicare Advantage and the [...]

iqtsupport2022-03-21T06:00:52-04:00March 21, 2022|Medicare reimbursement policy, MedPAC|