Posted
on September 28, 2023
The following is the latest health policy news from the federal government for September 22-28. Some of the language used below is taken directly from government documents.
The White House
President Biden has signed H.R. 2544, the Securing the U.S. Organ Procurement and Transplantation Network Act, which provides for awarding multiple grants, contracts, or cooperative agreements to operate the Organ Procurement and Transplantation Network.
Congress
Congressional leaders have not come to agreement on how to avert a federal government shutdown this weekend. While Senate leaders introduced a continuing resolution that would fund the government through November 17, that bill has not passed the Senate, and in the House, Speaker McCarthy has said that chamber will not consider such a measure. House Republicans have not proposed a continuing resolution.
Critical health and human services programs would continue during a federal government shutdown, including Medicare payments and Medicaid funding for the states, although some delays could be possible. Find HHS’s FY 2024 contingency staffing plan here and CMS’s plan here.
Without congressional action before October 1, $8 billion in reductions to state Medicaid disproportionate share (Medicaid DSH) allotments will begin to go into effect and it will be up to …
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Centers for Medicare & Medicaid Services,
Congress,
COVID-19,
health equity,
MACPAC,
Medicaid,
Medicaid and CHIP Payment and Access Commission,
Medicaid disproportionate share,
Medicaid DSH,
Medicaid DSH allotments,
Medicare,
Telehealth
Posted
on August 24, 2023
The following is the latest health policy news from the federal government for August 11-24. Some of the language used below is taken directly from government documents.
Centers for Medicare & Medicaid Services
- After suspending the No Surprises Act-created Independent Dispute Resolution process in the wake of a court ruling striking down a recent increase in fees for that process, CMS has established a new rate structure for initiating the adjudication of payment disagreements between providers and payers. It explains the new rate structure in this new FAQ, which nevertheless notes that despite the creation of new rates, the Independent Dispute Resolution process remains suspended until further notice.
- CMS has updated the ICD-10 MS-DRG grouper version 41 with changes that will take effect on October 1. Go here for further information, additional resources, and links to downloads.
- CMS has posted a brief animated explainer video, “Social Determinants of Health Items: Determining When a Proxy Response is Allowed,” to help home health, hospice, and long-term-care hospitals determine when the use of a proxy response is permitted for the following social determinants of health items: A1005 – ethnicity; A1010 – race; A1110 – language; A1250 – transportation; B1300 – health literacy;
…
Filed under:
Accountable Care Organization,
ACO,
Alternative payment models,
Center for Medicare and Medicaid Innovation,
Centers for Medicare & Medicaid Services,
CMMI,
COVID-19,
health equity,
MACPAC,
Medicaid,
Medicaid and CHIP Payment and Access Commission,
Medicaid managed care,
Medicaid regulations,
Medicare,
Medicare post-acute care,
Medicare reimbursement policy,
MedPAC,
social determinants of health
Posted
on August 10, 2023
The following is the latest health policy news from the federal government for August 4-10. Some of the language used below is taken directly from government documents.
Centers for Medicare & Medicaid Services
- CMS has temporarily suspended the federal Independent Dispute Resolution process, which adjudicates problems involving surprise medical bills, in the wake of a federal court ruling that found some of the process’s underlying regulations invalid. CMS has directed the certified Independent Dispute Resolution entities to pause all dispute resolution activities. As a result, providers and insurers temporarily cannot initiate new disputes. Learn more from this CMS notice.
- CMS has written to all 50 states with its review of their progress toward redetermining Medicaid eligibility as part of the Medicaid unwinding process. Its letters include data on states’ call center performance, renewal application processing times, and procedural termination rates. The letters point out areas where states are not meeting performance expectations and offer suggestions for improving that performance. Find the letters here.
- CMS has issued a toolkit for Medicaid and CHIP agencies to foster improvements in access, quality, and equity in postpartum care in their Medicaid and CHIP programs. This technical assistance has two components: quality improvement
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Filed under:
Alternative payment models,
Centers for Medicare & Medicaid Services,
COVID-19,
hospitals,
MACPAC,
Medicaid,
Medicaid and CHIP Payment and Access Commission,
Medicare,
Medicare reimbursement policy,
MedPAC,
Telehealth
Posted
on July 28, 2023
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 basket and modifies regulations to permit hospitals to open and begin billing Medicare for an excluded IRF unit anytime within the cost reporting year. Learn more from this CMS fact sheet and from this preview version of the final rule.
- CMS has published a final rule to update Medicare payment policies and rates under its inpatient psychiatric facility prospective payment system for FY 2024. The final rule calls for a rate increase of 3.3 percent. In addition, the rule finalizes CMS’s proposals to rebase and revise the inpatient psychiatric facility market basket; modifies regulations to permit hospitals to open and
…
Filed under:
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
Posted
on July 20, 2023
The following is the latest health policy news from the federal government for March 13-16. Some of the language used below is taken directly from government documents.
Congress
- Senator Bernie Sanders (I-VT), chair of the Senate Health, Education, Labor and Pensions (HELP) Committee, has introduced a bill, the “Primary Care and Health Workforce Expansion Act.” The bill would:
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- Increase funding for community health centers by $65 billion over five years, fund the National Health Service Corps at $8.3 billion over five years, and provide $250 million for HRSA coordination for the Women, Infants, and Children (WIC) program.
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- Add 10,000 graduate medical education (GME) slots over five years; reauthorize the Children’s Hospital Graduate Medical Education Program and the Teaching Health Center Graduate Medical Education Program; and reauthorize, expand, and fund other teaching and training programs for primary care, rural health care, and programs at historically Black colleges and universities (HBCUs).
- Reauthorize, expand, and create training programs and grant and loan programs to increase the number of nurses.
- Reauthorize and increase funding to increase the number of dentists,
- Create new programs and fund existing programs to expand the behavioral health workforce, the direct care workforce, and the number of family caregivers.
To …
Filed under:
Alternative payment models,
Center for Medicare and Medicaid Innovation,
Centers for Medicare & Medicaid Services,
Congress,
COVID-19,
health equity,
MACPAC,
Medicaid,
Medicaid and CHIP Payment and Access Commission,
Medicare,
Medicare regulations,
Medicare reimbursement policy
