Noteworthy News

 

Medicaid Expansion Helping Diabetics

The Affordable Care Act’s Medicaid expansion has led to a 40 percent increase in the number of prescriptions for diabetes medicine filled in the 30 states that expanded their Medicaid programs. Meanwhile, there was no change in the number of diabetes-related prescriptions filled in states that did not expand their Medicaid programs. This is considered important because it suggests that many low-income people who either could not afford their diabetes medicine or whose illness was undiagnosed are now being treated for the disease – a significant development because every diabetic who is treated for the condition represents a cost savings [&hellip

Medicare Announces FY 2019 Inpatient Payments

The Centers for Medicare & Medicaid Services has released its FY 2019 payment schedule for Medicare inpatient services. Highlights of the FY 2019 inpatient prospective payment system regulation include: A 1.75 percent increase in fee-for-service rates. A $1.5 billion increase in Medicare disproportionate share hospital payments (Medicare DSH). Major reductions of the quality measures hospitals must report for Medicare’s inpatient quality reporting and value-based purchasing programs. A requirement that hospitals post their standard charges on the internet. Learn about these and other aspects of Medicare’s FY 2019 inpatient prospective payment system regulation by seeing this Medicare fact sheet or go [&hellip

Battle Over Medicaid Work Requirements Not Over

The Secretary of Health and Human Services is not accepting a recent federal court ruling as the final word on Medicaid work requirements. Although the court ruled against a federally approved plan to permit the state of Kentucky to implement a work requirement for some able-bodied Medicaid recipients, HHS Secretary Alex Azar insists that his department will continue to support work requirements for Medicaid beneficiaries. Azar told a Heritage Foundation audience that We suffered one blow in district court in litigation, but we are undeterred.  We’re proceeding forward…We’re fully committed to work requirements and community participation in the Medicaid program…we [&hellip

GAO Looks at Medicaid Managed Care Spending

The federal government should do more to help states ensure the accuracy and integrity of their payments to Medicaid managed care organizations and the payments those Medicaid managed care organizations make to health care providers. This is the conclusion reached in a new study of Medicaid managed care performed by the U.S. Government Accountability Office at the request of the Permanent Subcommittee on Investigations of the Senate Committee on Homeland Security and Government Affairs. The GAO study identified six payment risks among various transactions between state governments, Medicaid managed care organizations, and health care providers.  The two biggest risks, the [&hellip

New Reg Pushes Medicare Toward Site-Neutral Outpatient Payments

Medicare would make more payments for outpatient services on a site-neutral basis under a newly proposed regulation just released by the Centers for Medicare & Medicaid Services. The 2019 Medicare outpatient prospective payment system regulation, published in proposal form, calls for: paying physician fee schedule rates rather than hospital outpatient rates at excepted off-campus provider-based departments; slashing payments for office visits; extending this year’s 340B prescription drug discount payments, already cut nearly 30 percent this year, to additional providers; and raising ambulatory surgical center rates and expanding the list of procedures that can be performed in such facilities so they [&hellip

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