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 April 27, 2023
The following is the latest health policy news from the federal government for April 21-27. 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 upon the expiration of the COVID-19 public health emergency on May 11. 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 posted a new FAQ that addresses its waivers and flexibilities upon the end of the COVID-19 public health emergency. Find it here.
- CMS has updated its “COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing” document to indicate that this FAQ will expire at the end of the COVID-19 public health emergency and will not be updated and directing stakeholders to other agency resources for answers to frequently asked questions. Go here to learn more.
Centers for Medicare & Medicaid Services
- CMS has issued a proposed rule that would reduce barriers to care for Deferred Action for Childhood Arrivals (DACA) individuals by removing
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Filed under:
Centers for Medicare & Medicaid Services,
COVID-19,
MACPAC,
Medicaid,
Medicaid and CHIP Payment and Access Commission,
Medicaid disproportionate share,
Medicaid DSH,
Medicaid DSH allotments,
Medicaid long-term services and supports,
Medicaid regulations,
Medicare,
Medicare reimbursement policy,
MedPAC
Posted
on April 20, 2023
The following is the latest health policy news from the federal government for April 8 – 20. Some of the language used below is taken directly from government documents.
The White House
The Biden administration has announced a plan to expand health coverage for Deferred Action for Childhood Arrivals (DACA) individuals. To this end, it announced that HHS will soon propose a rule amending the definition of “lawful presence,” for purposes of Medicaid and Affordable Care Act coverage, to include DACA recipients. If finalized, the rule would make DACA individuals eligible for these programs for the first time. Under the proposed rule, DACA individuals would be able to apply for coverage through the health insurance marketplace, where they may qualify for financial assistance based on income, and through their state Medicaid agency. Learn more from this White House fact sheet. HHS Secretary Xavier Becerra has released a letter on the same subject.
Congress
Congresswoman Yvette Clarke (D-NY) has introduced H.R. 2665, the Supporting Safety Net Hospitals Act, bipartisan legislation that would delay pending cuts to Medicaid disproportionate share hospital (Medicaid DSH) payments. Currently, Medicaid DSH payments would be cut, beginning in 2024, by $8 billion a year through 2027. …
Filed under:
Affordable Care Act,
Centers for Medicare & Medicaid Services,
Congress,
COVID-19,
health equity,
hospitals,
MACPAC,
Medicaid,
Medicaid and CHIP Payment and Access Commission,
Medicaid disproportionate share,
Medicaid DSH,
Medicare,
Medicare post-acute care,
Medicare regulations,
Medicare reimbursement policy,
MedPAC,
post-acute care
Posted
on March 23, 2023
The Medicaid and CHIP Payment and Access Commission has issued its annual report to Congress on the state of Medicaid and the Children’s Health Insurance Program.
The commission, a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the Department of Health and Human Services, and the states on a wide array of subjects, issues a report every year at this time. This year’s report focuses primarily on:
- Medicaid race and ethnicity data collection and reporting
- principles for assessing Medicaid nursing facility payment programs
- strengthening evidence under Medicaid drug coverage
- MACPAC’s statutorily required review of hospital payment policy for the nation’s safety-net hospitals – specifically, to report on Medicaid disproportionate share hospital (Medicaid DSH) allotments to states.
On the subject of Medicaid DSH, MedPAC states that
As in prior years, the Commission continues to find little meaningful relationship between state DSH allotments and the number of uninsured individuals; the amounts and sources of hospitals’ uncompensated care costs; and the number of hospitals with high levels of uncompensated care that also provide essential community services for low-income and uninsured populations.
Learn more about MACPAC’s perspective on Medicaid and CHIP in its …
