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
Posted
on February 6, 2023
The following is the latest health policy news from the federal government for the week of January 23 to February 6. Some of the language used below is taken directly from government documents.
340B
- Pharmaceutical companies may restrict the ability of providers to use specialty and community pharmacies to distribute 340B-covered drugs, a federal appeals court has decided. See the court’s ruling here.
Centers for Medicare & Medicaid Services
- CMS has revised its fact sheets about COVID-19 public health emergency waivers and flexibilities for different types of providers, updating which waivers and flexibilities have already been terminated, which have been made permanent, and which will end at the end of the public health emergency on May 11. Find the updated fact sheets here.
- CMS has written to state Medicaid officials about Medicaid continuous enrollment changes, conditions for receiving the Families First Coronavirus Response Act temporary increase in federal Medicaid matching funds, and enforcement provisions in the Consolidated Appropriations Act of 2023. Find the letter here.
- CMS has announced a marketplace special enrollment period (SEP) for qualified individuals and their families who lose Medicaid or CHIP coverage due to the end of continuous Medicaid enrollment. This SEP will
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Posted
on December 1, 2022
The following is the latest health policy news from the federal government for the week of November 28 to December 1. Some of the language used below is taken directly from government documents.
340B
- HHS and its Health Resources and Services Administration (HRSA) have proposed revising the current 340B administrative dispute resolution process. Since the current process was introduced in 2020 HRSA has encountered policy and operational challenges with its implementation and now proposes revising it and is soliciting comment on its proposed new approach. Changes include changing the nature of the dispute resolution process, using different kinds of professionals to adjudicate disputes, moving the process closer to certain legislative requirements, and creating a process for reconsideration for those unhappy with decisions. Learn more about how the proposed rule would change the administrative dispute resolution process from this HHS notice, which also includes a link to a more detailed Federal Register notice. Comments are due by January 30.
Confidentiality of Substance Use Disorder Patient Records
- HHS and its Office for Civil Rights and the Substance Abuse and Mental Health Services Administration (SAMHSA) have proposed changes in the Confidentiality of Substance Use Disorder Patient Records under 42 CFR part 2,
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Filed under:
340b,
Affordable Care Act,
Center for Medicare and Medicaid Innovation,
Centers for Medicare & Medicaid Services,
CMMI,
Congress,
COVID-19,
health equity,
hospitals,
MACPAC,
Medicaid,
Medicaid and CHIP Payment and Access Commission,
Medicaid and housing,
Medicaid long-term services and supports,
Medicaid regulations,
Medicare,
MedPAC,
Telehealth
Posted
on November 3, 2022
The following is the latest health policy news from the federal government for the week of October 31 to November 3. Some of the language used below is taken directly from government documents.
Medicare Payment Regulations
In the past week CMS has published four regulations presenting how it will pay providers in the coming year.
- Outpatient prospective payment system – CMS announced a 3.8 percent increase for Medicare outpatient and ambulatory surgical payments. It also adopted its proposal to establish rural emergency hospitals as a new kind of hospital provider; removed 11 surgical procedures from its inpatient-only list and authorized four new procedures to be performed in outpatient settings; extended the use of telehealth in the provision of Medicare-covered behavioral health services; authorized outpatient prospective payment system-level payments for outpatient services provided at rural sole community hospitals’ off-campus provider-based departments; and more. This rule also includes changes to the 340B program, see below for more details. Learn more about these and other changes from:
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Posted
on October 27, 2022
The following is the latest health policy news from the federal government for the week of October 21 to October 27. Some of the language used below is taken directly from government documents.
340B
- Responding to a federal court ruling that the federal government has shortchanged hospitals in its payments for 340B-covered prescription drugs, CMS has announced how it will compensate hospitals for its underpayments – at least for the 2023 fiscal year. According to CMS, it “…will apply the default rate (generally ASP plus 6%) to 340B-acquired drugs for the rest of the year. CMS also will reprocess claims our contractors paid on or after September 28, 2022, using the default rate (generally ASP plus 6%).” Learn more here.
Centers for Medicare & Medicaid Services
- CMS has published a guide for states on how they can maximize the use of automation when they review current Medicaid participants’ eligibility when the COVID-19 public health emergency ends, doing so by using reliable information that is already available to state Medicaid agencies and without seeking information directly from the individuals whose Medicaid eligibility is under review. Learn more from the CMS document “Ex Parte Renewal: Strategies to Maximize Automation,
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