Archive for Medicare

 

Federal Health Policy Update for November 17

The following is the latest health policy news from the federal government for the week of November 11 to 17.  Some of the language used below is taken directly from government documents.

Provider Relief Fund

  • Providers that cited extenuating circumstances for failing to submit Provider Relief Fund financial reports on time for reporting period 3 and were approved to submit their reports late must submit those late reports by December 2.  Learn more here.

Centers for Medicare & Medicaid Services

  • CMS has posted three downloadable sample formats that hospitals can use to meet federal requirements for posting in a machine-readable format their prices for a selected range of medical services.  Find them here (scroll down to the first three listings under “Resources”).
  • CMS has written to state Medicaid and CHIP officials describing 2023 and 2024 updates to the Core Set of children’s health care quality measures for Medicaid and the Children’s Health Insurance Program and the Core Set of health care quality measures for adults enrolled in Medicaid.  CMS encourages states to use Core Set data to identify disparities in care and to develop targeted quality improvement efforts to advance health equity, so these updates could affect the data

117th Congress’s Waning Hours

In addition to its biggest challenge – funding the federal government, authorization for which ends on December 16 – Congress has a number of health care issues on its agenda that at least some lawmakers and health care industry stakeholders would like to see it address before the year ends.

Those issues include the cut in Medicare payments to physicians scheduled to take place on January 1; the desire of many to make permanent some of the flexibilities to use telehealth that were temporarily authorized in response to the COVID-19 public health emergency; additional pandemic funding for new vaccines, new treatments, and more; reorganization of the Food and Drug and Administration; and more.

Learn more about these priorities in the Washington Post article “It’s lame-duck time.  Here are Congress’s health priorities.”…

Federal Health Policy Update for November 10

The following is the latest health policy news from the federal government for the week of November 7 to 10.  Some of the language used below is taken directly from government documents.

Centers for Medicare & Medicaid Services

  • CMS has published a notice advising teaching hospitals that they have until November 18 to ask Medicare to reconsider their per resident amounts or resident caps as shown in the Hospital Cost Report Information System (HCRIS) associated with cost reports that, as of July 1, 2022, were not reopenable.  Learn more from this CMS notice.
  • Due to an unplanned system outage of the No Surprises Act Independent Dispute Resolution (IDR) portal on November 8 and 9, initiating parties may not have been able to submit a Notice of IDR Initiation webform, complete IDR entity selection responses via the webform, and/or submit their IDR Notice of Offer webform.  This system issue has now been resolved.  The Departments have granted a four-day extension for initiating parties to get the Notice of IDR Initiation webform to submit IDR payment disputes where the open negotiation period expired on November 8, 9, or 10; a four-day extension for non-initiating parties of affected disputes to gain access the IDR Entity

MedPAC Meets

The government agency that advises Congress on Medicare payment matters met publicly in Washington, D.C. last week.

During the virtual meeting, members of the Medicare Payment Advisory Commission discussed and debated:

  • differences in quality measure results across Medicare populations
  • policy options for increasing Medicare payments to primary care clinicians
  • aligning fee-for-service payment rates across ambulatory settings
  • mandated report: evaluation of a prototype design for a post-acute care prospective payment system
  • supporting Medicare safety-net hospitals

MedPAC is an independent congressional agency that advises Congress on issues involving Medicare.  While its recommendations are not binding on Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

For a look at the agenda for the two-day meeting and to find the presentations for each of these subjects, go here.…

FEDERAL HEALTH POLICY UPDATE FOR November 3

The following is the latest health policy news from the federal government for the week of October 31 to November 3.  Some of the language used below is taken directly from government documents.

Medicare Payment Regulations

In the past week CMS has published four regulations presenting how it will pay providers in the coming year.