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 …
Filed under:
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 June 26, 2023
To improve “…the relationship between total state and federal DSH [Medicaid disproportionate share] funding and the number of non-elderly low-income individuals in a state,” the Medicaid and CHIP Payment and Access Commission has urged Congress to direct the Department of Health and Human Services to change how it calculates Medicaid DSH allotments to the states.
This year MACPAC devotes a significant portion of its annual report to Congress to payment policy for safety-net hospitals, and in summarizing its proposal it writes that:
- In order to reduce the wide variation in state disproportionate share hospital (DSH) allotments based on historical spending, Congress should revise Section 1923 of the Social Security Act to require the Secretary of Health and Human Services to develop a methodology to distribute reductions in a way that gradually improves the relationship between total state and federal DSH funding and the number of non-elderly low-income individuals in a state, after adjusting for differences in hospital costs in different geographic areas.
- Congress should amend Section 1923 of the Social Security Act to ensure that total state and federal disproportionate share hospital funding is not affected by changes in the federal medical assistance percentage.
- Congress should amend the Social Security
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Posted
on June 22, 2023
The following is the latest health policy news from the federal government for June 9-22. Some of the language used below is taken directly from government documents.
Centers for Medicare & Medicaid Services
- CMS has announced new flexibilities to help keep Americans insured as states resume Medicaid and Children’s Health Insurance Program (CHIP) renewals. The new flexibilities were announced in a letter sent by HHS Secretary Xavier Becerra to the nation’s governors urging them to adopt all available flexibilities to minimize avoidable coverage losses among children and families. The new flexibilities include permitting managed care plans to assist people currently covered by Medicaid with completing their renewal forms, including completing certain parts of the renewal forms on their behalf; permitting states to delay administrative terminations for one month while they conduct additional targeted outreach; and permitting pharmacies and community-based organizations to facilitate reinstatement of coverage for those who were recently disenrolled for procedural reasons based on presumptive eligibility criteria. Learn more from the following resources:
…
Filed under:
Center for Medicare and Medicaid Innovation,
Centers for Medicare & Medicaid Services,
COVID-19,
hospitals,
MACPAC,
Medicaid,
Medicaid and CHIP Payment and Access Commission,
Medicaid DSH,
Medicaid DSH allotments,
Medicare,
Medicare post-acute care,
Medicare reimbursement policy,
MedPAC,
Telehealth
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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