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House E&C Advances Telehealth Extension

On September 18, the House Energy and Commerce (E&C) Committee held a full committee markup and advanced 16 bills. The committee unanimously advanced the Telehealth Modernization Act (H.R. 7623), the widely anticipated...more

CMS Releases Technical Guidance to States on Complying with Medicaid Access Final Rule

On July 12, CMS released a companion guide to the Ensuring Access to Medicaid Services final rule (the “Access Final Rule”). This technical guidance—which focuses on the provisions regarding fee-for-service (FFS) payment...more

Senate Finance Explores Medicare Physician Payment and Graduate Medical Education Reform

On May 17, the Senate Finance Committee released a long-awaited white paper describing its legislative effort focused on bolstering chronic care through physician payment. Following a committee hearing April 11, the white...more

HHS Announces Medicaid and Medicare Flexibilities, Investigations post-Change Healthcare Cyberattack

Since becoming aware of the cyberattack on Change Healthcare in late February, the Centers for Medicare & Medicaid Services (CMS) has announced a number of flexibilities to support affected providers that have experienced...more

State-Directed Payments: Overview, Trends and Proposed Changes

In 2020, Medicaid spent $220.8 billion on hospital care. Hospital care accounted for 33% of Medicaid spending. Supplemental payments are critical for closing the gap between hospital costs and Medicaid reimbursement,...more

Upcoming Regulatory Changes Associated With the End of the PHE

At 11:59 p.m. on Thursday, May 11, 2023, the COVID-19 public health emergency (PHE) declaration will conclude, more than three years after taking effect in January 2020. The PHE declaration has enabled the U.S. Department of...more

The Pennsylvania Rural Health Model: Lessons Learned and What’s Next for Rural Payment Policies

Since 2010, a reported 140 rural hospitals have closed their doors, including a record 19 hospitals in 2020 alone as a result of the financial pressures of COVID-19 compounded by many other long-standing challenges facing...more

CMS Sets Parameters for Optional Medicaid Health Home Benefit for Medically Complex Children

On August 1, CMS released a State Medicaid Director letter (SMD) laying out a new option for states to cover “health home” services for Medicaid-eligible children and youth with medically complex conditions. This benefit was...more

House Passes Legislation to Extend Medicare Telehealth Flexibilities Through 2024

This week, the House voted overwhelmingly in support of the Advancing Telehealth Beyond COVID-19 Act of 2022 (H.R. 4040). The legislation targets many of the key temporary Medicare telehealth flexibilities that are currently...more

Senate Lays Groundwork for Fall Health Care Negotiations Before Recessing This Month

The Big Picture - Before leaving for its August recess, the Senate made progress on two major Biden Administration priorities by passing bipartisan infrastructure legislation and a fiscal year (FY) 2022 budget resolution....more

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