No Surprises Act independent dispute resolution process

Federal Health Policy Update for July 31

The following is the latest health policy news from the federal government for July 25-31. Some of the language used below is taken directly from government documents. Congress The House recessed last week and the Senate is still in session. When Congress returns in September its top priority will be funding the federal government before the fiscal year ends on September 30, likely requiring a continuing resolution to avoid a shutdown. Several major health care programs and extenders are set to expire at the end of the fiscal year, including Medicaid DSH allotments, telehealth flexibilities, the Acute Hospital Care at [...]

joe2025-07-31T15:04:29-04:00July 31, 2025|340b, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare reimbursement policy, Telehealth|

Court Sides Again With Providers on No Surprises Act

A federal appellate court has affirmed a lower court ruling that the manner in which federal regulations tell No Surprises Act dispute arbiters to evaluate competing fee claims unfairly favors health care payers over providers. At issue is a regulatory directive that arbiters weigh what is known as the qualifying payment amount – the median of what insurers contract to pay providers in a given geographic area – when deciding on payments. In February a federal court ruled that using this measure in what is known as the independent dispute resolution process unfairly stacked the arbitration process in favor of [...]

joe2024-08-08T16:52:09-04:00August 12, 2024|Uncategorized|

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 [...]

iqtsupport2022-08-23T17:33:16-04:00August 23, 2022|Centers for Medicare & Medicaid Services, COVID-19, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|