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. 
National Government Services (NGS) – which is part of the Anthem health insurance company – has been conducting audits on use of the MOON form and, as a result, has been routinely denying hospital observation claims.
President Trump released his proposed FY21 budget last year and it is remarkable for the ferocity with which it attacks Medicare and Medicaid.
President Donald Trump delivered his State of the Union address last Tuesday, in which he pledged to guarantee coverage for patients with pre-existing conditions, protect Medicare, and sign legislation to dramatically “lower prescription prices.”
MHA joins numerous organizations across the country, including AHA, in its criticism of of a new CMS Medicaid proposal.
The Trump Administration unveiled its newest version of Medicaid block grants last Thursday –a proposal it calls “Healthy Adult Opportunity.”
The regulatory-legal merry-go-round relating to Medicare reimbursement of certain services provided at grandfathered off-campus hospital provider-based departments continues.
Hospitals had about a week of rejoicing over a CMS decision to repay hospitals the Medicare funds it withheld relating to certain services provided at grandfathered off-campus hospital provider-based departments.
CMS has relented and will repay hospitals across the U.S. that sued to recover reimbursement cuts resulting from CMS’s so-called site-neutral policy.
Last month, CMS issued a final national rule that would require hospitals to make their standard charges public.
The National Quality Forum (NQF) weighed in, to a limited extent, on the five-star hospital rating system. is up and running, helping individuals locate substance use disorder treatment facilities across the U.S.
CMS is pushing ahead with “Primary Care First” – a voluntary, five-year alternative payment model to reduce Medicare spending.
U.S. Rep. Joseph Kennedy pressed CMS Administrator Seema Verma to defend the administration-endorsed efforts to impose work requirements on Medicaid recipients.
A U.S. District Court has invalidated a CMS regulation issued last November that treated payments made to hospital outpatient departments the same as those made to physician offices.
CMS has issued a proposed rule that includes a radiation oncology (RO) model to test whether prospective, bundled payments for 90-day radiotherapy episodes of care would reduce Medicare spending while preserving or improving care.
The much-maligned system of rating hospitals by one-to-five stars that CMS has used since 2016 will, unfortunately, remain as is throughout 2020.
Last week, the Trump Administration released a final rule pertaining to immigration that will ultimately make it more difficult for many immigrants to access healthcare. MHA and others have strongly opposed the revised rule from the outset, and remai
The Centers for Medicare and Medicaid Services (CMS) last week released the proposed payment rule for outpatient services as well as the physician fee schedule rule.
Last week, the U.S. Department of Health and Human Services announced that it would convene a summit to streamline HHS’ quality programs.
CMS has announced a funding opportunity for state Medicaid programs to help them create programs to address substance use disorders (SUD).


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.