Posted
on July 13, 2023
The following is the latest health policy news from the federal government for June 30 – July 13. Some of the language used below is taken directly from government documents.
340B
CMS has published a proposed regulation outlining how it plans to reimburse hospitals for reductions in 340B prescription drug payments that it implemented from 2018 to 2022 but that a federal court found to be illegal. The agency calculates that it owes participating 340B providers $9 billion, which it proposes paying to those providers in single lump-sum payments. CMS also proposes offsetting these payments through reductions in future non-drug and service outpatient payments that would be in effect for 16 years. Learn more from this CMS fact sheet; this CMS regulatory announcement about the proposed regulation, which includes a link to a formal Federal Register notice; and this CMS web page that includes downloadable files that list the payments CMS intends to make to eligible providers. The deadline for submitting comments on the proposed rule is September 11.
No Surprises Act
- HHS and its Office of the Assistant Secretary for Planning and Evaluation (ASPE) have issued a report to Congress on the impact of the
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Filed under:
340b,
Affordable Care Act,
Center for Medicare and Medicaid Innovation,
Centers for Medicare & Medicaid Services,
CMMI,
COVID-19,
health equity,
hospitals,
MACPAC,
Medicaid,
Medicaid and CHIP Payment and Access Commission,
Medicare,
Medicare post-acute care,
Medicare regulations,
Medicare reimbursement policy
Posted
on May 25, 2023
The following is the latest health policy news from the federal government for May 19-25. Some of the language used below is taken directly from government documents.
Congress
The House Energy and Commerce Committee has advanced to the full House two bills with significant implications for health care providers.
- H.R. 3561 calls for delaying $8 billion a year in Medicaid DSH cuts for two years – cuts scheduled to take effect in October; imposing site-neutral payments for drug infusion services provided in off-campus hospital outpatient departments; imposing stronger price transparency requirements on hospitals; and requiring hospitals to report selected ownership information to the federal government.
- H.R. 3290 would impose new reporting requirements on participants in the 340B prescription drug discount program.
Centers for Medicare & Medicaid Services
- CMS has updated its FAQ on waivers and flexibilities after the end of the COVID-19 public health emergency. Among the issues the revised FAQ addresses are hospital billing for services delivered via telehealth, including such matters as billing for originating site facility fees (including when patients are served by hospital-based outpatient departments), clinic visits, mental health services provided remotely; and billing for “hospitals without walls” services. The FAQ also addresses changes in COVID-19-related
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Posted
on May 18, 2023
The following is the latest health policy news from the federal government for May 12-18. Some of the language used below is taken directly from government documents.
Congress
The House Energy and Commerce Health Subcommittee has approved and advanced five bipartisan health care bills.
- H.R. 3281 combined a number of proposals into a larger package and includes provisions that would:
- delay for two years Medicaid disproportionate share (Medicaid DSH) cuts currently scheduled to take effect on October 1;
- require health providers to use a unique identifier for each off-campus or remote outpatient department beginning in 2026;
- change how Medicare pays off-campus hospital outpatient departments that are currently paid the site-neutral rate under the outpatient prospective payment system. Those departments would submit a professional bill instead of a hospital bill and would be paid the physician fee schedule rate. The bill does not expand site-neutral payment policy to off-campus hospital outpatient departments that are currently excepted; and
- reauthorize and increase funding for teaching health centers, community health centers, and the National Health Services Corps.
- H.R. 2666 would enable states to strike outcomes-based contracts for prescription drugs, which the committee believes would help improve access and reduce costs for expensive gene and
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Posted
on May 11, 2023
The following is the latest health policy news from the federal government for May 5-11. Some of the language used below is taken directly from government documents.
End of the COVID-19 Public Health Emergency
- DeBrunner & Associates has prepared a summary of the status of selected government health care waivers and flexibilities following expiration of the COVID-19 public health emergency today. The DeBrunner summary covers telehealth, COVID-19 treatment and coverage, flexible hospital operations, long-term-care hospitals, inpatient rehabilitation facilities and units, patient cost-sharing, and state Medicaid waivers. Find the summary here.
- CMS has sent a memo to state Medicaid and CHIP programs about the end of the COVID-19 public health emergency and the COVID-19 national emergency and the implications for Medicaid and CHIP. Find that memo here.
- The CDC has posted information about how its role and responsibilities will change with the end of the COVID-19 public health emergency. Some of those changes involve the data it will collect from providers and how it will share that data. Find this new information here. Another CDC bulletin, with a greater emphasis on COVID-19 surveillance, offers a more detailed and technical explanation. Find it here.
- The White House has
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Posted
on March 10, 2023
The following is the latest health policy news from the federal government for March 6-10. Some of the language used below is taken directly from government documents.
White House FY 2024 Budget Proposal
The Biden administration this week released its proposed FY 2024 federal budget. Among its many proposals are measures to extend the life of the Medicare hospital trust fund and reduce Medicare beneficiaries’ health care costs; to reduce prescription drug costs for consumers, Medicare, and Medicaid; to return high Medicaid managed care organization profits to the federal government; to make behavioral health care more affordable for seniors; to expand the health care workforce; to improve access to care in rural areas and among underserved communities; to improve HIV/AIDS and hepatitis C prevention and treatment for Medicaid participants; and more. Learn more about the health care aspects of the administration’s budget proposal from this White House fact sheet on its Medicare proposal; additional White House fact sheets; this HHS news release outlining the budget’s health care highlights; and the budget document itself, where the Department of Health and Human Services section begins on page 75.
Centers for Medicare & Medicaid Services
- CMS has posted anticipated 2023 state
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Filed under:
340b,
Accountable Care Organization,
ACO,
Alternative payment models,
Centers for Medicare & Medicaid Services,
COVID-19,
Medicaid,
Medicaid and CHIP Payment and Access Commission,
Medicaid disproportionate share,
Medicaid DSH,
Medicaid DSH allotments,
Medicaid managed care,
Medicaid regulations,
Medicare post-acute care,
Medicare regulations,
Medicare reimbursement policy,
MedPAC
