The Ranking Members of the Senate Health, Education, Labor & Pensions (HELP) Committee Bill Cassidy (R-LA) and Ranking Member of the Senate Agriculture Committee John Boozman (R-AR) sent a letter to the Biden Administration requesting information on how it is developing federal nutrition guidelines in the Dietary Guidelines for Americans, 2025. The Dietary Guidelines are developed and updated every five years, and are then… (McClurg, April 17, 2024) #Nutrition

The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session on Medicaid Unwinding. Principal Analysis and Research Advisor Martha Heberlein led panelists through a discussion exploring the lessons learned, the information available on policy successes and failures, and beneficiary experiences. Commissioners expressed an interest in continuing to explore topics such as state flexibilities that should continue beyond the… (Marceno, April 13, 2024) <span style="font-size:90%;

The Centers for Disease Control and Prevention (CDC) is seeking nominations for membership on the Healthcare Infection Control Practices Advisory Committee (HICPAC). HICPAC consists of 14 experts in fields including, but not limited to, infectious diseases, infection prevention, healthcare epidemiology, nursing, clinical and environmental microbiology, surgery, hospitalist medicine, internal medicine, epidemiology, health policy, health services research, public health, and related… (Eisen, April 15, 2024) #Mid-Level Practitioners, #Physicians, #Primary Care, #Public Health

The Medicaid and CHIP Payment and Access Commission (MACPAC) met to vote on updated recommendations to improve transparency in Medicaid and CHIP financing as well as optimizing state Medicaid agency contracts. All recommendations were approved as drafted. Recommendations for Improving Transparency in Medicaid and CHIP Financing: Recommendation 1.1: In order to improve transparency and enable analyses of net Medicaid payments,… (Marceno, April 13, 2024) #Coverage Decisions, #COVID-19, #Health Equity

The Medicare Payment Advisory Commission (MedPAC) convened a session to discuss various approaches to updating payments under the Medicare Physician Fee Schedule (MPFS). Under current law, starting in 2026, eligible clinicians engaged in advanced alternative payment models (A-APMs) will see their payment rates under the physician fee schedule rise by 0.75 percent annually, while all other clinicians will experience a 0.25 percent increase. However,… (Colocho, April 12, 2024) #Insurance Reform, #Medicare Access and Chip Reauthorization Act of 2015 (MACRA), #Physicians, #Primary Care, #Quality

The Senate Finance Committee convened a hearing to begin discussions on a potential overhaul of the Medicare physician payment system. The hearing highlighted concerns regarding low physician adoption rates for Medicare reimbursements related to advance care planning, administrative burdens like prior authorization, and disparities in Medicare Advantage (MA) payments compared to traditional Medicare. Committee members heard from the following witnesses… (Colocho, April 12, 2024) #Accountable Care Organizations, #Chronic Diseases, #Costs, #Demonstration Programs, #Insurance Reform, #Medicare Access and Chip Reauthorization Act of 2015 (MACRA), #Medicare Advantage, #Physicians, #Prevention, #Primary Care, #Rural Health, #Telehealth, #Transparency, #Value-Based Insurance Design

The Medicare Payment Advisory Commission (MedPAC) convened a session to discuss alternative approaches to lower payments for services provided in inpatient rehabilitation facilities (IRFs) for select conditions that are also treated in skilled nursing facilities (SNFs). This work builds upon MedPAC’s 2023 report on a unified payment system for post-acute care in which the Commission stated that policymakers may want… (Llamas, April 11, 2024) #Inpatient Rehabilitation Facilities, #Skilled Nursing Facilities

The Medicare Payment Advisory Commission (MedPAC) convened a follow-up session to examine Medicare Advantage (MA) encounter data completeness. In March, MedPAC staff compared encounter data to provider-reported data which showed that while data completeness is increasing, gaps remain (Impact Summary). In this session, MedPAC staff compared encounter data to plan-reported data, bid data and HEDIS data, which highlighted incremental improvements… (Eisen, 1/1/70) #Medicare Advantage, #Quality

Today, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2025 inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) proposed rule (press release, fact sheet), which applies to acute care hospital and LTCH payments beginning Oct. 1, 2025. Under the proposed rule, acute care hospitals would receive a 2.6 percent increase ($3.2 billion… (McClurg, April 10, 2024) #Demonstration Programs, #Disproportionate Share Hospitals (DSH), #Graduate Medical Education (GME), #Health Equity, #Hospitals, #Long-Term Care, #Long-Term Care Hospitals, #Quality

The Senate Finance Health Subcommittee hosted a roundtable panel discussion on opportunities to improve substance use disorder care in federal health programs. Roundtable participants shared their expertise in the treatment of substance use disorder, with particular insights on treatment for adolescents and providing care in community-based settings. The participants shared their collective frustration with barriers to prescribing methadone, prior authorization… (Marceno, April 10, 2024) #Health Equity, #Mental and Behavioral Health, #Opioids