MedPAC

Federal Health Policy Update for January 18

The following is the latest health policy news from the federal government for January 12-16.  Some of the language used below is taken directly from government documents. Congress Medicaid DSH With a partial government shutdown looming on Friday, January 19, congressional leaders have agreed to extend the current stopgap legislation temporarily funding the federal government.  Under this agreement, the four spending bills scheduled to expire this Friday would be extended until March 1 and the eight bills set to expire on February 2 would be extended until March 8.  The appropriations bill that funds health and human services is included [...]

MedPAC Meets, Finalizes 2025 Payment Recommendations

2025 Medicare payments led the agenda at last week’s meeting of the Medicare Payment Advisory Commission. After hearing presentations on the various Medicare payment systems and discussing the adequacy of current Medicare reimbursement, MedPAC’s commissioners voted to recommend the following changes in 2025 Medicare payments. Inpatient and outpatient services – an update provided for in current law plus 1.5 percent and a shift to a safety-net index policy that would pay safety-net hospitals another $4 billion. Physicians and other health professionals – an increase of 50 percent of the Medicare economic index and introduction of an add-on payment for services [...]

Federal Health Policy Update for January 11

The following is the latest health policy news from the federal government for January 5 - 11.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS will establish 200 new Medicare-funded residency slots in FY 2025.  Learn more about the additional slots here and find information about how to apply for those slots here.  The deadline for applications is March 31. CMS released guidance for Medicare Part D plans that describes coverage and processing claims for COVID-19 therapeutics.  Medicare Part D plans must cover commercially available oral antivirals for COVID-19 [...]

Federal Health Policy Update for December 14

The following is the latest health policy news from the federal government for December 8-14.  Some of the language used below is taken directly from government documents. MedPAC Rate Recommendations At their latest public meeting, members of the Medicare Payment Advisory Commission voted preliminary approval of the following rate updates for 2025 Medicare payments: Inpatient and outpatient services –update provided for in current law plus 1.5% and adoption of a safety-net index policy to pay safety-net hospitals another $4 billion. Physicians and other health professionals –update of 50% of the Medicare economic index and a new add-on payment for services [...]

MedPAC Meets, Makes 2025 Payment Recommendations

2025 Medicare payments led the agenda at last week’s meeting of the Medicare Payment Advisory Commission. After hearing presentations on the various Medicare payment systems and discussing the adequacy of current Medicare reimbursement, MedPAC’s commissioners provisionally endorses the following changes in 2025 Medicare payments. Inpatient and outpatient services – an update provided for in current law plus 1.5 percent and a shift to a safety-net index policy that would pay safety-net hospitals another $4 billion. Physicians and other health professionals – an increase of 50 percent of the Medicare economic index and introduction of an add-on payment for services provided [...]

MedPAC Meets

The commissioners of the Medicare Payment Advisory Commission recently met virtually.  The subjects on the agenda of their two-day meeting were: rural emergency hospitals dual-eligible special needs plans MedPAC’s work plan for hospice issues Medicare coverage of and payment for software as a medical service favorable selection in Medicare Advantage network management and prior authorization and their impact on access in Medicare Advantage 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 highly influential in governing circles and its recommendations often find [...]

Federal Health Policy Update for November 9

The following is the latest health policy news from the federal government for November 3-9.  Some of the language used below is taken directly from government documents. Congress Senate Finance Committee Earlier this week the Senate Finance Committee passed the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023.  The bill, which passed out of the committee by a vote of 26-0, would: eliminate $16 billion in cuts to Medicaid DSH for 2024 and 2025; soften the 2024 cut to Medicare physician payments by reducing the conversion factor by 2.15 percent rather than the 3.4 percent that CMS [...]

Federal Health Policy Update for October 26

The following is the latest health policy news from the federal government for October 20-26.  Some of the language used below is taken directly from government documents. Congress More than three weeks after House Republicans voted Rep. Kevin McCarthy (CA) out of the speaker’s office, the House has elected Rep. Mike Johnson (LA) to the position.  Speaker Johnson is a social conservative and has pushed for cuts to Medicare and Medicaid, including plans to roll back Medicaid expansion in 2019. The Speaker has said he intends for the House to take up as many FY 2024 spending bills as possible [...]

MedPAC Outlines Plans for the Coming Year

The Medicare Payment Advisory Commission has shared its agenda for its 2023-2024 public meeting cycle. According to MedPAC, it will engage in its regular work of offering recommendations to Congress on the adequacy of Medicare payments to providers and, as needed, suggest changes in those payments.  In addition, it will fulfill two statutory requirements in the coming year:  to evaluate Medicare Advantage special needs plans for individuals eligible for both Medicare and Medicaid and to review the new “Rural Emergency Hospital” designation. In addition, MedPAC writes that We are working on several other issues in the Medicare program as well, [...]

Federal Health Policy Update for October 12

The following is the latest health policy news from the federal government for October 6-12.  Some of the language used below is taken directly from government documents. No Surprises Act CMS has reopened the federal independent dispute resolution (IDR) portal for the initiation ofnew single disputes, including single disputes involving bundled payment arrangements, but parties still cannot initiate new disputes involving air ambulance services and batched disputes for air ambulance and non-air ambulance items and services.  IDR portal functionalities related to previously initiated batched disputes also are unavailable.  Learn more about this action from this CMS announcement, which includes an [...]

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