Medicare/ Medicaid

Medicare is a federal program that pays for certain healthcare expenses for individuals age 65 or older. MHA monitors prospective and recently implemented changes to Medicare and MassHealth, provides information about how specific aspects of the programs affect care providers, and advocates for fair and equitable implementation of the program. 
CMS issued its proposed Outpatient Prospective Payment System rule for FY19 last week and an initial review shows that it has the potential to adversely affect hospitals.
Clinicians who participated in the Merit-based Incentive Payment System in 2017 can now access their final MIPS score and performance feedback.
Last week, the Centers for Medicare and Medicaid Services responded to the state’s 1115 Medicaid Waiver request that had been filed last September.
CMS will not update Hospital Compare’s quality star ratings in July as scheduled.
The IPPS proposed rule would significantly reduce the number of quality measures hospitals have to report.
A federal proposed rule to allow short-term, limited-duration insurance could expose individuals to higher healthcare costs.
The U.S. House Ways & Means Committee has issued a white paper summarizing comments the committee received on the opioid crisis within the Medicare program.
The House Ways & Means Committee version of the FY2019 state budget is expected to be released by the committee this Wednesday.
MHA weighed in with the House Ways & Means Committee as it prepares to take the next step in the state’s budget process.
Last Monday, the Trump Administration released its FY2019 budget proposal.
Hospitals are concerned that negotiations over how to raise budget caps may result in further Medicare cuts.
CMS posted a statement saying that it would begin the process to implement the statutorily required therapy cap.
01.29.2018  | Transition
The nation’s new Health & Human Services Secretary is Alex Azar.
The three-day government shutdown came to an end last Monday when Congress passed a continuing resolution package.
Since 1976 there have been 17 federal government shutdowns.
The Trump Administration announced it would allow state Medicaid programs to seek a Medicaid waiver that would allow states to require certain Medicaid beneficiaries to be either working or preparing to work as a requirement to receive Medicaid.
A U.S. District Court dismissed a lawsuit regarding a Medicare policy that would reduce hospital payments under the 340B program.
SB1174, HB1181/SB1183, SB1269, HB1136, HB1137, HB1207, HB3250, SB1248, SB1270, HB1175, HB1197, SB1230, HB2441, HB2477, HB3514, SB1212, SB1234 Healthcare Facilities
Providers participating in the Medicaid or Medicare program are facing new “Conditions of Participation”
Last Thursday CMS cancelled two mandatory bundled payment models – relating to hip fracture and cardiac care – that were scheduled to begin on January 1.

Resources

Click on the links below for easy access to information on important federal healthcare matters and MHA’s advocacy, outreach and other work on these issues.

Both of these include links to members list, committees, and legislation and records.