Medicaid Highlighted in Latest Health Affairs
The journal Health Affairs has dedicated its July 2015 edition to “Medicaid’s Evolving Delivery Systems.” The edition includes the following articles about different aspects of Medicaid: “Medicaid’s Growing Role in Care Delivery” Once a Welfare Add-On, Medicaid Takes Charge in [...]
GAO Reports on 340B Program
The U.S. Government Accountability Office (GAO) recently completed a review of the federal 340B Drug Pricing Program. The program, which requires pharmaceutical companies to provide drug discounts to qualified hospitals that serve especially large proportions of low-income patients, has come [...]
Medicaid Cost-Sharing Re-Emerges
States are beginning to look anew at imposing cost-sharing requirements on their Medicaid population. Indiana now requires Medicaid recipients to contribute to health savings accounts, Arkansas and Iowa have cost-sharing requirements, and Arizona, Ohio, and Utah are considering introducing cost-sharing. [...]
Medicare Proposes Changes in Two-Midnight Rule
The Centers for Medicare & Medicaid Services (CMS) has unveiled a proposal for long-awaited changed in its controversial Medicare “two-midnight rule.” The changes, part of the agency’s proposed 2016 Medicare outpatient prospective payment system regulation released last week, include: changes [...]
Medicare Proposes 2016 Outpatient Payment Policies
The Centers for Medicare & Medicaid Services (CMS) has published its proposed Medicare outpatient prospective payment system regulation for calendar year 2016. Among the changes it has proposed are: a cut in outpatient rates clarification of chronic care management payments [...]
Medicaid Limits on High-Cost Drugs Illegal?
With the recent proliferation of high-cost drugs threatening many states’ Medicaid budgets, some of those states have attempted to impose limits on the use of those drugs. But are those limits legal? That is the question addressed in a new [...]
More Value-Based Care in Medicare’s Future
The Affordable Care Act placed a new, stronger emphasis on the provision of “value-based care” to Medicare beneficiaries, and that trend appears likely to continue in the coming years. The Commonwealth Fund has taken an in-depth look at Medicare value-based [...]
Report on Public Health and Health Care
The Institute of Medicine (IOM) has published a report summarizing its February workshop that explored the relationship between public health and health care. According to the IOM, the workshop … was designed to discuss and describe the elements of successful [...]
CMS Issues Guidance on Medicaid Managed Care Rate-Setting
The federal government has provided new guidance to states concerning how to ensure that the rates they pay Medicaid managed care organizations are adequate. While federal law has long required that such rates be “actuarially sound,” the Centers for Medicare [...]
NAUH Comments on Proposed Medicare Regulation (Part 4 of 4)
On April 30, the Centers for Medicare & Medicaid Services (CMS) published a 1500-page draft regulation detailing how it proposed paying hospitals for the inpatient care they provide to their Medicare patients in FY 2016 and invited comment on its [...]
