MedPAC

MedPAC Meets

The members of the Medicare Payment Advisory Commission held their latest public meeting last week. The issues addressed during the meeting were: Current legal updates to Medicare’s payment rates for clinician services. Staffing ratios and turnover rates in nursing facilities. An alternative method to establish Medicare payments for selected conditions treated in inpatient rehabilitation facilities. A staff work plan for examining prices of generic drugs under Part D For an overview of each of these issues and links to the presentations made by MedPAC’s staff during the discussions, go here.

iqtsupport2023-10-12T13:00:04-04:00October 12, 2023|Centers for Medicare & Medicaid Services, Medicare, Medicare reimbursement policy, MedPAC, post-acute care|

Federal Health Policy Update for October 5

The following is the latest health policy news from the federal government for September 29 to October 5. Some of the language used below is taken directly from government documents. Congress Last Saturday, Congress passed a 45-day continuing resolution (CR) to fund the federal government through November 17. Part of that limited CR includes a delay of the scheduled $8 billion cut to Medicaid DSH allotments to states through the end of the CR. The bill also extends funding for community health centers and the National Health Services Corps for the same length of time. Congress will have to act [...]

iqtsupport2023-10-05T14:53:32-04:00October 5, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for September 21

The following is the latest health policy news from the federal government for September 15 - 21. Some of the language used below is taken directly from government documents. Congress With only nine days left in the current federal fiscal year, Congress still has not agreed on any kind of spending bill to keep the federal government operating past September 30. If the federal government shuts down, the Department of Health and Human Services (HHS) will “use the full extent of the authority under the Antideficiency Act (ADA) to maintain existing HHS activities…” In previous shutdowns, Medicare has continued to [...]

iqtsupport2023-09-21T15:37:11-04:00September 21, 2023|Alternative payment models, Congress, COVID-19, Medicaid, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for September 14

The following is the latest health policy news from the federal government for September 8-14. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has posted a guide providing details about how it calculates scores for its Merit-Based Incentive Payment System in the 2023 performance year. Find the guide by going here, scrolling down to “Full Resource Library,” and clicking “2023 Traditional MIPS Scoring Guide” for a direct download of the guide. CMS has posted a notice about a data breach at a CMS contractor, Maximus Federal Services, Inc. (Maximus), [...]

iqtsupport2023-09-14T16:59:54-04:00September 14, 2023|Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicare|

Federal Health Policy Update for September 7

The following is the latest health policy news from the federal government for September 1-7. Some of the language used below is taken directly from government documents. Congress House Republicans plan to introduce the Lower Cost, More Transparency Act for consideration before the end of the year. This bill includes provisions passed by three committees with health care jurisdiction: House Ways & Means, Energy & Commerce, and Education & Workforce. Some of the bill’s provisions would: eliminate scheduled Medicaid DSH cuts for FY 2024 and FY 2025; reauthorize and extend funding for the Community Health Center program, the National Health [...]

iqtsupport2023-09-07T16:39:42-04:00September 7, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|

Federal Health Policy Update for August 31

The following is the latest health policy news from the federal government for August 25-31. Some of the language used below is taken directly from government documents. No Surprises Act For the second time in less than a month a court has rejected how federal agencies are implementing the Independent Dispute Resolution process of the No Surprises Act. A federal court concluded that the process for establishing the Qualifying Payment Amount, or QPA – the median rate insurers pay for in-network services and a critical factor in settling payment disputes – inappropriately permits insurers to depress that rate and unfairly [...]

iqtsupport2023-08-31T16:09:59-04:00August 31, 2023|Centers for Medicare & Medicaid Services, Medicaid, Medicare, MedPAC|

Federal Health Policy Update for July 28

The following is the latest health policy news from the federal government for July 21 -28. Some of the language used below is taken directly from government documents. Medicare Payment Regulations CMS has published a final rule to update Medicare payment policies and rates under its inpatient rehabilitation facility (IRF) prospective payment system and IRF quality reporting program for FY 2024. The final rule includes a 3.4 percent rate increase and changes in the outlier threshold, the case-mix-group relative weights and average length of stay values, and the wage index. In addition, this rule rebases and revises the IRF market [...]

iqtsupport2023-07-28T14:28:17-04:00July 28, 2023|Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|

MedPAC Urges Congress to Embrace Site-Neutral Medicare Outpatient Payments

Medicare should pay for outpatient care on a site-neutral basis, MedPAC has told Congress in its annual recommendations. Proponents of such a change – including the Medicare Payment Advisory Commission – argue that Medicare should not pay more for services than it needs to and can, if it believes hospital-associated facilities deserve more money, find better ways to provide such additional resources. They also believe such a policy encourages the acquisition of independent medical practices by operators that then increase the price of the same services and that site-neutral payments would help preserve such independent practices while also driving down [...]

iqtsupport2023-06-26T06:00:56-04:00June 26, 2023|Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for June 22

The following is the latest health policy news from the federal government for June 9-22. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced new flexibilities to help keep Americans insured as states resume Medicaid and Children’s Health Insurance Program (CHIP) renewals. The new flexibilities were announced in a letter sent by HHS Secretary Xavier Becerra to the nation’s governors urging them to adopt all available flexibilities to minimize avoidable coverage losses among children and families. The new flexibilities include permitting managed care plans to assist people currently [...]

iqtsupport2023-06-22T16:04:30-04:00June 22, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, Telehealth|

Health Policy Update for June 8

The following is the latest health policy news from the federal government for May 28 – June 8. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has announced a new primary care model – the Making Care Primary Model – that will be tested by the Center for Medicare and Medicaid Innovation in eight states. The model seeks to improve care for patients by expanding and enhancing care management and care coordination, equipping primary care clinicians with tools to form partnerships with health care specialists, and leveraging community-based connections [...]

iqtsupport2023-06-08T16:41:06-04:00June 8, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, MedPAC|