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HHS OIG Scrutinizes Medicare Advantage Use of Health Risk Assessments

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

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

Government Funding Will Dominate Post-Convention Congressional Session

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

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

Energy and Commerce Chair Releases Framework with Recommendations to Overhaul NIH

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

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

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

Access to Care for Justice-Involved Pregnant People With a Substance Use Disorder

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

What Changes if the COVID-19 Public Health Emergency Ends May 11

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

Biden Administration Takes Action Following Supreme Court Decision Overturning Roe v. Wade

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

Congress Includes Medicare, Medicaid and Other Health Policies in Omnibus FY 2022 Spending Bill

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

What’s Ahead for Federal Health Policy in 2022

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

Build Back Better: All Eyes on the Senate

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

CMS Innovation Center’s Strategic Plan to Drive Health System Change in the Next Decade

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

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