Medicare

Administration to Propose Extending Medicare Solvency and Lowering Beneficiary Costs

Later this week the Biden administration will offer proposals that seek to extend the solvency of the Medicare Trust Fund and reduce beneficiaries’ health care costs. As part of the proposed FY 2024 federal budget the administration will present this week, it will call for extending the solvency of the Medicare Trust Fund by increasing the Medicare tax rate on income greater than $400,000 a year; closing loopholes in current Medicare taxes and depositing Medicare net investment income tax proceeds into the Medicare Trust Fund; and crediting savings from proposed prescription drug reforms to that same trust fund. To reduce [...]

iqtsupport2023-03-08T13:00:58-05:00March 8, 2023|Medicare|

Seven Apply for Rural Emergency Hospital Designation

With more than 140 rural hospitals closing since 2010 and more currently in financial trouble, a modest number of such facilities are hoping to avoid a similar fate by applying to the Centers for Medicare & Medicaid Services to become “rural emergency hospitals,” a new Medicare provider type created to preserve access to care in rural areas. Hospitals that become rural emergency hospitals will receive an annual fee of more than $3 million from Medicare and a five percent increase in their Medicare payments but must retain 24-hour emergency services while limiting their inpatient services to leave just enough time [...]

iqtsupport2023-03-08T06:00:26-05:00March 8, 2023|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for March 3

The following is the latest health policy news from the federal government for February 27 to March 3. Some of the language used below is taken directly from government documents. No Surprises Act The Independent Dispute Resolution (IDR) entities empowered by the No Surprises Act to adjudicate disagreements between providers and payers may resume their work – but only some of it. CMS has directed IDRs entities to resume processing payment determinations on February 27 for disputes involving items or services furnished before October 25, 2022 but not to issue decisions involving items or services furnished on or after October [...]

iqtsupport2023-03-03T13:20:02-05:00March 3, 2023|Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, MedPAC, Telehealth|

The Emergence of “Food as Medicine”

In both the public and private sectors, a growing movement is working to integrate food as part of medical treatment – and have health care payers foot the bill. From the administration’s granting of Medicaid waivers to Arkansas, Massachusetts, and Oregon to use state and federal money to pay for food for some beneficiaries to Congress tucking $2 million into an appropriations bill for a “food is medicine pilot program” to the NIH developing a $140 million grant program that will lead to the designation of “food is medicine centers of excellence,” providers and policy-makers are showing unprecedented interest in [...]

iqtsupport2023-02-27T06:00:08-05:00February 27, 2023|health equity, Medicaid, Medicare, social determinants of health|

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 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 [...]

iqtsupport2022-11-08T06:00:13-05:00November 8, 2022|hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

On Second Thought, CMS Decides to Share Hospital Performance Data

After originally proposing not to publish certain recent hospital performance data because it feared it might be skewed by COVID-19-related challenges, the Centers for Medicare & Medicaid Services has decided to go ahead and publish that data – but not to use it in Medicare payment calculations. Under Medicare’s hospital-acquired condition program, hospitals are rated on their performance on ten safety indicators. Regulators, however, feared that doing so based on hospital performance during the pandemic might penalize hospitals whose communities were especially hard hit by the pandemic. Patient safety groups opposed CMS’s April proposal to withhold the data and the [...]

iqtsupport2022-08-05T09:04:52-04:00August 5, 2022|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare reimbursement policy|

Nearly Half of Hospitals Nicked for Readmissions

Medicare’s Hospital Readmissions Reduction program will penalize 2499 hospitals for excessive readmissions in the coming year. That represents 47 percent of all hospitals covered by the program. The average penalty for the nearly 2500 hospitals will be a 0.64 percent reduction of their Medicare payments. Thirty-nine hospitals will suffer the maximum penalty: a three percent cut of their Medicare payments. Learn more about the effect the Hospital Readmissions Reduction Program has had on hospitals – and on patients admitted to the hospital with specific medical conditions – in the Kaiser Health News story “Medicare Punishes 2,499 Hospitals for High Readmissions.”

iqtsupport2021-11-01T06:00:12-04:00November 1, 2021|Medicare|

Medicare Beneficiaries Happier With Their Health Insurance Than Privately Insured

People who are enrolled in Medicare are happier with their health insurance than those with private health insurance, according to a recent JAMA report. Researchers found that the privately insured had a more difficult time finding doctors, were less likely to have a personal physician, had to deal with higher medical costs, were more likely to have medical debt, were more likely not to fill prescriptions because of their cost, and were less satisfied with their care than people insured by Medicare. The findings were true whether people purchased their own health insurance or had employer-sponsored insurance. Learn more about [...]

iqtsupport2021-06-03T06:00:26-04:00June 3, 2021|Medicaid, Medicare|

Federal Health Policy Update for Thursday, April 22

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, April 22. Department of Health and Human Services COVID-19 HHS’s Office of the Assistant Secretary for Preparedness and Response has published a new edition of its online publication The Exchange. The issue focuses on the work of hospital allied and supportive care providers during COVID-19 and is divided into three subjects: COVID-19 and acute hospital care, home care, and hospice; the role of allied health care professionals; and engineering and environmental support during COVID-19. For each subject the issue directs readers to [...]

iqtsupport2021-04-22T17:30:26-04:00April 22, 2021|Coronavirus, COVID-19, Medicare, Medicare regulations|