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
…
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 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 …
Posted
on March 16, 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.
Medicare Payment Advisory Commission (MedPAC)
MedPAC has published its “March 2023 Report to the Congress: Medicare Payment Policy.” In this year’s report MedPAC considers the context of the Medicare program, including the near-term consequences of COVID-19 and the longer-term effects of program spending on the federal budget and the program’s financial sustainability. It evaluates payment adequacy and make recommendations concerning Medicare payment policy in 2024 for selected fee-for-service payment systems but explains that it has discontinued its practice of offering rate recommendations for long-term-care hospitals (LTCHs) and ambulatory surgical centers, citing inadequate data on which to base recommendations. It offers recommendations to redistribute current Medicare disproportionate share hospital (Medicare DSH) and uncompensated care payments and to provide additional resources to Medicare safety-net hospitals and clinicians who furnish care to Medicare beneficiaries with low incomes. Finally, MedPAC reviews the current state of the Medicare Advantage program (Part C) and its prescription drug program (Part D).
MedPAC’s rate recommendations to Congress and the administration, which it approved at its January 2023 meeting and which are …
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,
Medicare,
Medicare disproportionate share,
Medicare DSH,
Medicare post-acute care,
Medicare regulations,
Medicare reimbursement policy,
MedPAC
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
…
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 March 3, 2023
The following is the latest health policy news from the federal government for February 27 to March 3. Some of the language used below is taken directly from government documents.
No Surprises Act
- The Independent Dispute Resolution (IDR) entities empowered by the No Surprises Act to adjudicate disagreements between providers and payers may resume their work – but only some of it. CMS has directed IDRs entities to resume processing payment determinations on February 27 for disputes involving items or services furnished before October 25, 2022 but not to issue decisions involving items or services furnished on or after October 25, 2022 until federal agencies can provide additional direction. The work of IDRs was brought to a halt by a federal court ruling last month that found that the process created by federal agencies to implement the No Surprises Act violated the terms of that law by unduly favoring health care payers over providers. Learn more about where the dispute resolution process stands and what providers and payers can expect from the federal agencies charged with responsibility for implementing the No Surprises Act from this CMS notice.
- The Congressional Research Service has published a brief overview of the No Surprises
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Filed under:
Centers for Medicare & Medicaid Services,
COVID-19,
health equity,
hospitals,
Medicaid,
Medicaid disproportionate share,
Medicaid DSH,
Medicaid DSH allotments,
Medicare,
MedPAC,
Telehealth
