Archive for post-acute care


Federal Health Policy Update for April 20

The following is the latest health policy news from the federal government for April 8 – 20.  Some of the language used below is taken directly from government documents.

The White House

The Biden administration has announced a plan to expand health coverage for Deferred Action for Childhood Arrivals (DACA) individuals.  To this end, it announced that HHS will soon propose a rule amending the definition of “lawful presence,” for purposes of Medicaid and Affordable Care Act coverage, to include DACA recipients.  If finalized, the rule would make DACA individuals eligible for these programs for the first time.  Under the proposed rule, DACA individuals would be able to apply for coverage through the health insurance marketplace, where they may qualify for financial assistance based on income, and through their state Medicaid agency.  Learn more from this White House fact sheet.  HHS Secretary Xavier Becerra has released a letter on the same subject.


Congresswoman Yvette Clarke (D-NY) has introduced H.R. 2665, the Supporting Safety Net Hospitals Act, bipartisan legislation that would delay pending cuts to Medicaid disproportionate share hospital (Medicaid DSH) payments.  Currently, Medicaid DSH payments would be cut, beginning in 2024, by $8 billion a year through 2027.  …

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:

  • reforming Medicare’s wage index system
  • addressing the high prices of drugs covered under Medicare Part B
  • a prototype design for a post-acute care prospective payment system
  • favorable selection and future directions for Medicare Advantage payment policy
  • aligning fee-for-service payment rates across ambulatory care settings

MedPAC is an independent congressional agency that advises Congress on issues involving Medicare.  While its recommendations are not binding on either 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.…

Future Financial Prospects Mixed for Post-Acute Providers, Analysis Suggests

Assisted living facilities, hospice, and home health providers should see their profitability rise over the next three years, according to a new analysis by McKinsey & Company.

Nursing homes and inpatient rehabilitation facilities, on the other hand, may see their profitability decline as they continue to struggle with the current shortage of qualified nurses.

Learn more about the near-term prospects for post-acute-care providers from the McKnight’s Long-Term Living article “Skilled nursing profits will shrink through 2026, even as other post-acute lines gain: analysis.”…

Federal Health Policy Update for October 27

The following is the latest health policy news from the federal government for the week of October  21 to October 27.  Some of the language used below is taken directly from government documents.


  • Responding to a federal court ruling that the federal government has shortchanged hospitals in its payments for 340B-covered prescription drugs, CMS has announced how it will compensate hospitals for its underpayments – at least for the 2023 fiscal year.  According to CMS, it “…will apply the default rate (generally ASP plus 6%) to 340B-acquired drugs for the rest of the year.  CMS also will reprocess claims our contractors paid on or after September 28, 2022, using the default rate (generally ASP plus 6%).”  Learn more here.

Centers for Medicare & Medicaid Services

  • CMS has published a guide for states on how they can maximize the use of automation when they review current Medicaid participants’ eligibility when the COVID-19 public health emergency ends, doing so by using reliable information that is already available to state Medicaid agencies and without seeking information directly from the individuals whose Medicaid eligibility is under review.  Learn more from the CMS document “Ex Parte Renewal:  Strategies to Maximize Automation,

Federal Health Policy Update for the Week of August 24 to September 2

The following is the latest health policy news from the federal government for the week of August 29 to September 2.  Some of the language used below is taken directly from government documents.

The White House

The White House has introduced a new “National HIV Strategy” for 2022-2025.  The new strategy updates the 2021 strategy and establishes targets for ending the HIV epidemic in the U.S. by 2030, including a 75 percent reduction in new HIV infections by 2025 and a 90 percent reduction by 2030.  Find the strategy here.

Proposed Changes in Medicaid, CHIP, and Basic Health Program Enrollment Processes

CMS and HHS have proposed a new rule to overhaul enrollment processes for Medicaid, the Children’s Health Insurance Program (CHIP), and basic health programs and to eliminate arbitrary coverage caps for children in CHIP.  The new rule seeks to simplify application and verification processes to make it easier for children, older adults, and people with lower incomes with Medicaid and CHIP coverage to enroll in and retain health insurance.  Highlights of the rule include:

  • limiting eligibility checks to once every 12 months
  • allowing applicants 30 days to respond to information requests
  • giving applicants 90 days to apply for