Medicare

Basic information and updates on the federal program to provide health insurance to the elderly.
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.”
The regulatory-legal merry-go-round relating to Medicare reimbursement of certain services provided at grandfathered off-campus hospital provider-based departments continues.
MHA is encouraging its membership to weigh in on recommendations for possible changes to the 2021 state Aligned Measure Set.
The deadline to submit 2019 data for the Centers for Medicare & Medicaid Services’ (CMS’) Medicare Promoting Interoperability Program is March 2, 2020.
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.
The National Quality Forum (NQF) weighed in, to a limited extent, on the five-star hospital rating system.
The CONNECT for Health Act would expand access to telehealth for Medicare patients.
CMS is pushing ahead with “Primary Care First” – a voluntary, five-year alternative payment model to reduce Medicare spending.
A new study from the Urban Institute and Commonwealth Fund outlines other ways to boost coverage and potentially lower costs.
President Trump last Thursday unveiled an executive order entitled “Protecting and Improving Medicare for Our Nation’s Seniors.”
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 Executive Office of Health and Human Services (EOHHS) has issued proposed changes to the two regulations governing Health Safety Net (HSN) eligibility and payments.
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.
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.
The US Senate Finance Committee advanced bi-partisan, compromise drug cost legislation on Thursday, despite opposition from a majority of the committee’s Republican members.
Last week, the U.S. Department of Health and Human Services announced that it would convene a summit to streamline HHS’ quality programs.

Resources

Click on the links below for easy access to important information related to state healthcare issues and advocacy.


Visit the Commonwealth of Massachusetts websites below to find information on legislative hearings and other meetings of interest to the healthcare community.


To guide your navigation of the legislative process and assist your advocacy efforts, please visit the following state websites: