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. 
The Trump Administration released its budget blueprint for federal fiscal year 2020 last week and, by any measure, it does not contain good news for Medicaid, Medicare, hospitals, or coverage expansion.
The 2018 Cost Trends Report from the Health Policy Commission released last month showed the persistent growth in prescription drug spending over the state’s healthcare cost growth benchmark.
Several new Massachusetts policies are aiding the collective fight against the opioid epidemic.
The state’s bold experiment with its dual eligible programs is getting some revisions, while raising some concerns among hospitals and physicians.
The American Hospital Association (AHA) last week laid out its 2019 public policy agenda.
In a letter to CMS last week, MHA urged the federal agency to reconsider rules regarding how Medicaid Managed Care Organizations (MCOs) direct payments to providers.
The U.S. Department of Health and Human Services has released a fact sheet related to the Physician-Focused Payment Model Technical Advisory Committee (PTAC).
Last week, Sen. Bernie Sanders (I-Vermont), along with several Democratic Senate and House members, including House Oversight Committee Chairman Elijah Cummings (D-Md.), announced the release of three bills intended to lower drug prices.
A U.S. District Court has issued a permanent injunction to CMS, halting the federal government’s nearly 30% reduction in reimbursements to certain hospital outpatient departments purchasing drugs through the 340B program.
State Attorney Generals across the U.S. will be working through the Christmas holiday preparing expedited briefs supporting the Affordable Care Act.
AHA and others are suing the federal government over a new rule that changes how certain off-campus hospital departments are reimbursed for the care they provide patients.
CMS recently released the final rule to update the Medicare fee-for-service outpatient prospective payment system and ambulatory surgical center payment system effective Jan. 1, 2019.
On September 26, the U.S. House passed a House/Senate FY2019 spending agreement for several agencies, including the U.S. Department of Health and Human Services.
AHA and other hospital interests filed suit in U.S. District Court to stop a nearly 30% reduction in Medicare payments to hospitals for purchase of outpatient drugs under the 340B 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.
A federal proposed rule to allow short-term, limited-duration insurance could expose individuals to higher healthcare costs.
The IPPS proposed rule would significantly reduce the number of quality measures hospitals have to report.

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.