Blog Archive

Prior Authorizations: An Introduction

[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text] Healthcare spending in the United States is expected to surpass $4.7 trillion in 2023. As Applied Policy has previously reported, some of that money may…

CMS Proposes FY 2024 Inpatient Payment Policies for Hospitals, Increasing Payment Rates, Advancing Equity, and Proposing Quality Reporting Changes (CMS-1785-P)

[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text] On April 10th, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2024 Hospital Inpatient Prospective Payment Systems (IPPS) for Acute…

CMS Finalizes CY 2024 Policy Changes for Medicare Advantage and Part D Plans Impacting Plan Utilization Management, Patient Protections, and Health Equity

[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text] On April 5, 2023, the Centers for Medicare & Medicaid Services (CMS) released its Medicare Program; Contract Year 2024 Policy and Technical Changes to the…

CMS Increases Payments for Inpatient Rehabilitation Facilities in FY 2024, Proposes Changes to the Quality Reporting Program

[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text] On April 3, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2024 Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS)…

For 2024, CMS Finalizes Changes Resulting in a 3% Increase in Plan Payments and Implements Inflation Reduction Act Provisions on Part D Benefit

[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text] The Centers for Medicare & Medicaid Services (CMS) has released its Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C…

An Overview of CMS Continuous Enrollment Condition Unwinding Webinar and Key Resources for Medicaid Stakeholders and Providers

[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text] In March 2020, the Families First Coronavirus Response Act established the “continuous enrollment condition,” which provided states with extra federal Medicaid funding in exchange for…

When medicine gets it wrong

[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text] We trust modern medicine to be evidence-based: grounded in the most current and reliable research available. But sometimes medicine gets it wrong, and clinicians engage…

MedPAC Holds March 2023 Meeting

[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text] On March 2 and 3, 2023, the Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting. The meeting included sessions on the following: Reforming…

MACPAC Holds March 2023 Meeting

[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text] The Medicaid and CHIP Payment and Access Commission (MACPAC) held a virtual public meeting on March 2, 2023. The meeting included sessions on additional analyses of…

CMS expands Medicare coverage for Continuous Glucose Monitors

[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text] The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have announced a policy change expanding coverage for continuous glucose monitors (CGMs). The decision, which the…

Certificates of need

[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text] Thirty-five states and the District of Columbia currently have some form of certificate of need (CON) requirement under which specified healthcare organizations—including hospitals, outpatient facilities, and long-term…

CMS eliminates requirement for CMNs and DIFs

[vc_row full_width=”stretch_row” gap=”35″][vc_column][vc_column_text] In what it described as part of “ongoing efforts to increase access to care and to reduce unnecessary administrative burdens for stakeholders,” The Centers for…

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