On October 24, the HHS Office of Inspector General (OIG) released a report titled “Medicare Advantage: Questionable Use of Health Risk Assessments Continues to Drive Up Payments to Plans by Billions.” In evaluating 2022 MA...more
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
10/2/2024
/ FQHC ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Medicare ,
Pending Legislation ,
Pharmacy Benefit Manager (PBM) ,
Regulatory Agenda ,
Rural Health Care Program ,
Rural Health Care Providers ,
Telehealth ,
Telemedicine
The post-convention Congressional session in September is likely to focus on keeping the government funded past the end of the current federal fiscal year on September 30, with the next opportunity for substantive health...more
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
On June 14, House Energy and Commerce Committee (E&C) Chair Cathy McMorris Rodgers published a “framework for discussion” proposing reforms to the National Institutes of Health (NIH)....more
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
6/3/2024
/ Alternative Payment Models (APM) ,
Chronic Care Managment (CCM) ,
Fee-for-Service ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Medicare ,
Medicare Part B ,
Physician Fee Schedule ,
Provider Payments ,
Senate Finance Committee
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
There is a critical need to increase access to evidence-based care for justice-involved pregnant people with a substance use disorder (SUD)—and connect them to continued coverage and care upon release—according to national...more
9/11/2023
/ American Medical Association ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
Drug & Alcohol Abuse ,
Food and Drug Administration (FDA) ,
Health Insurance ,
Healthcare ,
Medicaid ,
New Guidance ,
Opioid ,
Patient Access ,
Pregnancy ,
Prisoners ,
Substance Abuse
The Biden Administration has announced that May 11, 2023, will be the final day of the COVID-19 public health emergency (PHE) declaration, which has been in effect since January 2020. Following the White House’s announcement...more
In the two weeks following the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, the Biden Administration has taken several actions to provide clarity about women’s access to reproductive health...more
7/11/2022
/ Abortion ,
Department of Health and Human Services (HHS) ,
Dobbs v. Jackson Women’s Health Organization ,
EMTALA ,
Equal Protection ,
Healthcare ,
Healthcare Reform ,
New Guidance ,
OCR ,
Patient Access ,
Regulatory Agenda ,
Reproductive Healthcare Issues ,
Roe v Wade ,
SCOTUS
After weeks of negotiations and months of temporary stopgap funding bills since the federal fiscal year started in October 2021, on Tuesday, the President signed the Consolidated Appropriations Act, 2022, an omnibus funding...more
3/17/2022
/ Biden Administration ,
Controlled Substances ,
Federal Funding ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medicare ,
New Legislation ,
Section 340B ,
Telehealth
As the Biden administration begins its second year in office, the administration remains focused on its core health policy agenda—advancing coverage, access and equity....more
2/4/2022
/ Biden Administration ,
Coronavirus/COVID-19 ,
Drug Pricing ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Infectious Diseases ,
Medicaid ,
Medicare ,
Public Health Insurance Marketplace ,
Surprise Medical Bills ,
Telehealth
The Big Picture -
On November 19, the House of Representatives passed the Build Back Better Act (BBB) (H.R. 5376) by a vote of 220–213. The BBB contains a number of health and social policy priorities that are widely viewed...more
12/8/2021
/ American Rescue Plan Act of 2021 ,
Biden Administration ,
Critical Infrastructure Sectors ,
Federal Budget ,
Federal Funding ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Home and Community Based Services (HCBS) ,
Low-Income Issues ,
Medicaid ,
Medicare ,
Pending Legislation ,
Popular ,
Prescription Drugs ,
Regulatory Agenda ,
Tax Credits
Last month, the Center for Medicare and Medicaid Innovation (the Innovation Center, or CMMI) released its long-anticipated white paper, “Innovation Strategy Center Refresh,” outlining the Innovation Center’s strategic outlook...more