On April 11 and 12, 2024, the Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting, which included the following sessions: Considering approaches for updating the Medicare physician fee schedule; Telehealth in Medicare: Status report; Alternative approaches to lowering Medicare payments for select conditions in inpatient rehabilitation facilities; Assessing consistency between plan-submitted data sources [...] Read More
On April 4, 2024, the Centers for Medicare & Medicaid Services (CMS) released its Medicare Program; Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Program for Contract Year 2024--Remaining Provisions and Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, [...] Read More
The counterpart to Medicaid’s Disproportionate Share Hospital (DSH) program, Medicare’s DSH program was established with the shared objective of providing financial support to hospitals that serve a large number of low-income patients. Yet, despite this common purpose, the two programs differ significantly in terms of operational frameworks, eligibility criteria, and policy issues. Background The impetus [...] Read More
On March 7 and 8, 2024, the Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting, which included the following sessions: Assessing data sources for measuring health care utilization by Medicare Advantage enrollees: Encounter data and other sources; Preliminary analysis of Medicare Advantage quality; Rural hospital and clinical payment policy: A workplan for 2024-2025; [...] Read More
For suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS, herein referred to as DME, except when referenced by a federal authority) included in Medicare’s competitive bidding program (CBP), the first quarter of 2024 has been defined by continuing regulatory and economic uncertainty. Following the expiration of its contracts for off-the-shelf (OTS) [...] Read More
On January 11 and 12, 2024, the Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting, which included the following sessions: Assessing payment adequacy and updating payments: Physician and other health professional services; Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; Assessing payment adequacy and updating payments: Outpatient dialysis services; hospice [...] Read More
On December 21, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule implementing an order from the Federal district court for the District of Connecticut in Alexander v. Azar.[1] See the fact sheet here. The rule would establish an appeals process for certain fee-for-service Medicare beneficiaries who believe hospitals incorrectly classified their [...] Read More
On December 14 and 15, 2023, the Medicaid and CHIP Payment and Access Commission (MACPAC) held a virtual public meeting. The meeting included the following sessions: Annual Analysis of Medicaid Disproportionate Share Hospital (DSH) Allotments to States; Potential Areas for Comment on CMS Proposed Rule on Medicare Advantage for CY 2025; and Medicare-Medicaid Plan (MMP) [...] Read More
On December 7 and 8, 2023, the Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting. In this meeting, MedPAC discussed its draft payment update recommendations. For each of the following types of services, MedPAC assessed payment adequacy based on beneficiaries’ access to care, quality of care, and the relationship between Medicare’s payments and [...] Read More
On November 2, the Centers for Medicare & Medicaid Services (CMS) issued the Hospital Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center (ASC) Payment Systems final rule with comment period, which finalizes updates to the OPPS and the Medicare ASC payment system for calendar year (CY) 2024. See the press release here. CMS has provided [...] Read More