Archive for Medicaid

 

Beneficiaries Starting to Feel Effects of Medicaid Unwinding

With the end of the COVID-19 public health emergency, states are now undertaking in earnest the challenge of reconsidering Medicaid eligibility for millions of people currently on their Medicaid rolls – something federal law has prohibited them from doing since the early days of the pandemic.

And while 65 percent of those currently enrolled in Medicaid, according to a recent survey, are unaware of the current process and the possibility that they may soon lose their Medicaid eligibility, states are already reconsidering beneficiaries’ eligibility.

Learn more about what has become known as “Medicaid unwinding” and the impact it is starting to have on long-time Medicaid participants, in Arizona, Florida, Pennsylvania, and elsewhere in the NPR report “In some states, hundreds of thousands dropped from Medicaid.”

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Federal Health Policy Update for May 25

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

Federal Health Policy Update for May 18

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

Federal Health Policy Update for May 11

The following is the latest health policy news from the federal government for May 5-11.  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 following expiration of the COVID-19 public health emergency today.  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 sent a memo to state Medicaid and CHIP programs about the end of the COVID-19 public health emergency and the COVID-19 national emergency and the implications for Medicaid and CHIP.  Find that memo here.
  • The CDC has posted information about how its role and responsibilities will change with the end of the COVID-19 public health emergency.  Some of those changes involve the data it will collect from providers and how it will share that data.  Find this new information here.  Another CDC bulletin, with a greater emphasis on COVID-19 surveillance, offers a more detailed and technical explanation.  Find it here.
  • The White House has

Federal Health Policy Update for May 4

The following is the latest health policy news from the federal government for April 28 – May 4.  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.
  • The COVID-19 public health emergency led to the temporary creation of a number of flexibilities in the delivery of health care, including one issued by the Drug Enforcement Agency (DEA) that made possible prescribing controlled medications via telehealth.  With the coming end of the public health emergency on May 11, and with it the expiration of some but not all COVID-related flexibilities, the DEA has announced that it is temporarily extending this flexibility while continuing to evaluate the situation.  It has submitted a draft regulation to the Office of Management and Budget to this effect but will provide no further information about it