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Archive Category: Healthcare Policy Development

CMS Finalizes CY 2023 Policy Changes for Medicare Advantage and Part D Plans; Including Patient Cost-Sharing, Patient Protections, and Provider Accessibility

On April 29, 2022, the Centers for Medicare & Medicaid Services (CMS) released its final rule and a fact sheet, containing policies for Medicare Advantage (MA) and Medicare Part D plans in CY (contract year) 2023. The rule includes the following changes: Redefining ‘negotiated price’ for Part D drugs so prices at point of sale [...] Read More

CMS Proposes 2023 Payments for Inpatient Hospitals

On April 18th, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (2023) proposed Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System rule. See the press release here. CMS has provided a rule overview fact sheet and maternal health fact sheet relating to [...] Read More

CMS Proposes Changes Increasing Inpatient Psychiatric Facility Payments and Seeks Comments on Future Payment Adjustments and Health Equity

On March 31, 2022, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2023 proposed rule for inpatient psychiatric facilities (IPFs), which includes proposed policies for payment and quality reporting in these facilities. CMS also released a fact sheet on the proposed rule. This year’s proposals are primarily payment related including [...] Read More

CMS Increases Payments for Inpatient Rehabilitation Facilities and Proposes Future Health Equity Considerations to the Quality Reporting Program

On March 31, 2022, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2023 proposed Inpatient Rehabilitation Facilities (IRFs) payment rule. The proposed rule includes the annual payment update and proposals related health equity in the IRF Quality Reporting Program. CMS released a fact sheet accompanying the rule. This proposed rule [...] Read More

CMS Finalizes Policies for Additional GME Slots, Organ Procurement Payment, & Decides Against Changes to 1115 Waiver Days (CMS-1752-FC3)

On the evening of December 17, 2021, the Centers for Medicare & Medicaid Services (CMS) released a follow-up to its final rule, Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Final Policy Changes and Fiscal Year 2022 Rates,[1],[2] which addresses policies that were proposed but [...] Read More

President’s Blog: CMS Is Not Prepared for Aduhelm

Two years ago, in my role as Chairman of the Board of the Alliance for Aging Research, I wrote about the failure of CMS to adequately reimburse for the use of PET amyloid scans to help diagnose Alzheimer’s disease. At that time, I noted that with the appropriate use of PET scans, which can detect [...] Read More

MedPAC Releases June Report to Congress

On June 15, 2021, the Medicare Payment Advisory Commission (MedPAC) released one of their two annual Reports to Congress.[1],[2] The report includes recommendations to revise Medicare Advantage (MA) benchmark policy, streamline the portfolio of alternative payment models (APMs), replace the existing skilled nursing facility value-based purchasing program, revise indirect medical education (IME) payments, and improve [...] Read More

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