Archive for Medicaid long-term services and supports

 

Federal Health Policy Update for April 27

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

FEDERAL HEALTH POLICY UPDATE FOR December 1

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,

Results of Annual Survey of State Medicaid Programs

The Kaiser Family Foundation has published the results of its annual survey of state Medicaid programs for the 2022 and 2023 fiscal years.  Among the survey’s findings (in language taken directly from the Kaiser report):

  • More than 3/4 of states that contract with MCOs [managed care organizations] enroll ≥75% of all beneficiaries in MCOs
  • Some states reported newly implementing or expanding MCO programs
  • States also report continued use of other service delivery and payment system reforms
  • Two-thirds of states are using strategies to improve race, ethnicity, and language data
  • About one-quarter of states are tying MCO financial incentives to health equity
  • States are also leveraging MCO contracts in other ways to promote equity-related goals
  • States report far more benefit expansions than benefit cuts
  • States are most frequently expanding behavioral health and pregnancy/postpartum services
  • Most states allow MCOs to cover “in lieu of” services, especially BH [behavioral health] and SDOH [social determinants of health] services
  • States have seen high telehealth utilization across Medicaid enrollees
  • States are addressing telehealth quality and other challenges
  • Most states are adopting permanent telehealth expansions, though some are considering limits

Other subjects addressed in the report include provider taxes and intergovernmental transfers, supplemental Medicaid payments, health equity, …

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

Supporting the discussion were the following briefing papers:

MACPAC is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department  of Health and Human Services, and the states on a wide variety of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP).  Find its web site here.…

Federal Health Policy Update for Wednesday, July 27

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, July 27.  Some of the language used below is taken directly from government documents.

Final Medicare Payment Regulations for FY 2023

  • CMS has issued its final FY 2023 Medicare inpatient rehabilitation facility (IRF) payment system regulation, finalizing a rate increase of 3.9 percent, which is greater than the 2.8 percent the agency proposed in April.  To learn more about CMS’s final IRF payment rule for FY 2023, see this CMS fact sheet and the final rule itself.
  • CMS also has finalized its Medicare inpatient psychiatric facility prospective payment system final rule for FY 2023, including a 2.5 percent rate increase.  Learn more from this CMS fact sheet and the final rule itself.
  • In addition, CMS has published its FY 2023 hospice payment rate update final rule, finalizing a 3.8 percent rate increase.  Learn more from this CMS fact sheet and from the final rule itself.

White House

The White House COVID-19 response team has briefed the press about the administration’s latest efforts in the response to COVID-19.  Find a transcript of its latest briefing here.

The White House …