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News by Topic: Health insurance

Jun 6, 2023 - The Centers for Medicare & Medicaid Services (CMS) is seeking comment on the following information collections: 1) Applicable Integrated Plan Coverage Decision Letter and 2) Uniform Institutional Providers Form. Comments are due by July 6, 2023.
Source: Federal Register
Jun 5, 2023 - Pre-publication notice of final rule from the Centers for Medicare & Medicaid Services (CMS) seeking comment removing expired language addressing staff and patient COVID-19 testing requirements for long term care facilities issued in the September 2, 2020, interim final rule. Among other things, this rule finalizes requirements for long-term care facilities to provide education about COVID-19 vaccines and to offer COVID-19 vaccines to residents, clients, and staff; and withdraws language on COVID-19 healthcare staff vaccination requirements in the November 5, 2021, interim final rule with comment. These regulations are effective August 4, 2023.
Source: Federal Register
Jun 5, 2023 - Pre-publication notice from the Centers for Medicare & Medicaid Services (CMS) making technical corrections to the April 12, 2023, final rule. This correction is effective June 5, 2023.
Source: Federal Register
Jun 1, 2023 - The Centers for Medicare & Medicaid Services (CMS) will hold a virtual public meeting of the Advisory Panel for Outreach and Education (APOE) on June 22, 2023, from 12:00 – 5:00 p.m. Eastern. Agenda items include remarks from CMS leadership; a recap of the April 2023 meeting; presentations on CMS programs, initiatives, and priorities; and a discussion of panel recommendations. Registration is required.
Source: Federal Register
May 31, 2023 - Notice from the Centers for Medicare and Medicaid Services (CMS) making technical corrections to the April 12, 2023, final rule. This correction is effective June 5, 2023.
Source: Federal Register
May 26, 2023 - The Agency for Healthcare Research and Quality (AHRQ) is seeking scientific information submissions to inform its review on Measures for Primary Healthcare Spending. Includes background information and key questions related to the review. The full research protocol is available for review on the AHRQ website. Submissions are due by June 26, 2023.
Source: Federal Register
May 26, 2023 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) that seeks to implement policies in the Medicaid Drug Rebate Program (MDRP) related to the new legislative requirements in the Medicaid Services Investment and Accountability Act of 2019 (MSIAA), which are needed to address drug misclassification, as well as drug pricing and product data misreporting by Manufacturers. Among other things, this proposed rule clarifies and establishes requirements for State fee-for-service (FFS) pharmacy reimbursement; codifies conditions relating to States claiming FFP for physician-administered drugs (PADs); designates drug price verification and transparency through data collection; and proposes two new contracting requirements between States and their Medicaid managed care plans. Includes information about the potential impact of this proposed rule on small rural hospitals. Comments are due by July 25, 2023.
Source: Federal Register
May 24, 2023 - Doctors offered ideas for improving health care in remote areas of Pennsylvania during a meeting of the Pennsylvania House Agriculture and Rural Affairs Committee on May 18 in Pittsburgh. Suggestions included increasing incentives, bolstering Medicaid, expanding use of community health workers, finding uses for disused hospitals, and enhancing broadband access.
Source: Lancaster Farming
May 24, 2023 - Rural Mississippi hospitals are increasingly endangered, as poverty, declining populations, and dwindling inpatient revenue chip away at profits. Federal aid appropriated during the pandemic seemed to slow the rate of closures, but now some are in worse shape than before, as they struggle with ongoing staff shortages and rising costs.
Source: Roll Call
May 22, 2023 - Describes challenges faced by women seeking maternity care in rural South Carolina counties. Infant death rates in South Carolina are higher than the national average, and a report published by the South Carolina Department of Health and Environmental Control shows the rate for non-Hispanic Black babies is growing worse. The death rate among infants born to Black mothers in the state increased by nearly 40% from 2017 to 2021.
Source: KFF Health News
May 22, 2023 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the extension of the Medicaid and CHIP Program (MACPro) generic clearance process umbrella and the individual generic collection of information requests that fall under the MACPro umbrella. Comments are due by July 21, 2023.
Source: Federal Register
May 22, 2023 - Announcement from the Centers for Medicare & Medicaid Services (CMS) of receipt of an application for initial recognition of the Center for Improvement in Healthcare Quality (CIHQ) as a national accrediting organization for psychiatric hospitals that wish to participate in the Medicare or Medicaid programs. Comments are due by June 21, 2023.
Source: Federal Register
May 22, 2023 - Announcement from the Centers for Medicare & Medicaid Services (CMS) of the approval of the Center for Improvement in Healthcare Quality (CIHQ) as a national accrediting organization for Critical Access Hospitals that wish to participate in the Medicare or Medicaid programs. The approval is effective June 1, 2023, to June 1, 2027.
Source: Federal Register
May 19, 2023 - Senators Susan Collins of Maine and Catherine Cortez-Masto of Nevada introduced legislation to ensure all communities, regardless of population, have access to adequate emergency medical services. The Protecting Access to Ground Ambulance Medical Services Act allows ambulance providers to be properly reimbursed by Medicare for the costs of providing emergency services, while also ensuring that existing EMT services, particularly in rural locations, remain operational, with sufficient staff and supplies.
Source: Office of Senator Susan Collins
May 19, 2023 - Explores healthcare issues facing disparate rural North Carolina counties, including hospital closures, drug overdose deaths, workforce shortages, and high rates of uninsured patients.
Source: North Carolina Health News
May 18, 2023 - The U.S. Department of Education (ED) is proposing a new rule that would streamline Medicaid billing permissions for students with disabilities. The Department of Health and Human Services is approving requests from New Mexico and Oregon to expand health care services that schools can deliver to Medicaid enrolled students.
Source: U.S. Department of Health and Human Services
May 18, 2023 - The Centers for Medicare and Medicaid Services is seeking comment on an information collection for Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment. The information gathered will be used by the Department of Health and Human Services (HHS) to run the permanent risk adjustment program on behalf of States that request HHS to run it for them. Comments are due July 17, 2023.
Source: Federal Register
May 12, 2023 - Quarterly listing of Centers for Medicare and Medicaid Services (CMS) manual instructions, substantive and interpretive regulations, and Federal Register notices published from January through March 2023, including contact information for general questions or additional information about specific sections.
Source: Federal Register
May 11, 2023 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the extension of the Home Health Agency Cost Report, Form CMS–1728–20. The cost report is used to determine a provider's reasonable cost incurred in furnishing medical services to Medicare beneficiaries and reimbursement due to or from a provider and for annual rate setting and payment refinement activities, including developing a home health market basket. Comments are due by July 10, 2023.
Source: Federal Register
May 10, 2023 - An HHS fact sheet outlining what is and is not changing around telehealth as the COVID-19 Public Health Emergency ends, including information on coverage of services. Provides guidance around licensure portability, a measure intended to increase access to healthcare for rural and underserved communities. Also outlines broadband initiatives that increase access to healthcare and reduce disparities.
Source: U.S. Department of Health and Human Services
May 9, 2023 - Describes anticipated nursing home closures in Iowa due to financial challenges from rising medical care costs and static Medicaid reimbursement rates. Notes that fewer long-term care facilities means other long-term care facilities and rural hospitals must absorb the communities served by the closed facilities. Iowa's aging population means that the strain of fewer long-term care facilities will impact the healthcare system far into the future.
Source: N'West Iowa REVIEW
May 8, 2023 - Notice from the U.S. Census Bureau making corrections to the April 28, 2023, notice seeking comment on proposed revisions to the Household Pulse Survey. The Census Bureau will begin collecting data using the revised survey on or about May 31, 2023.
Source: Federal Register
May 4, 2023 - The Centers for Medicare & Medicaid Services (CMS) is seeking comment on the following information collections: 1) Medicare Enrollment Application for Institutional Providers; 2) Medicare Advantage, Medicare Part D, and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey; and 3) End-stage Renal Disease (ESRD) Quality Incentive Program (QIP): Study of Quality and Patient Experience. Comments are due by June 5, 2023.
Source: Federal Register
May 3, 2023 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) proposing improvements that aim to increase transparency and accountability, standardize data and monitoring, and create opportunities for States to promote active beneficiary engagement in their Medicaid programs, with the goal of improving access to care. Comments are due by July 3, 2023.
Source: Federal Register
May 3, 2023 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) that would advance CMS' efforts to improve access to care, quality and health outcomes, and better address health equity issues for Medicaid and Children's Health Insurance Program (CHIP) managed care enrollees. The proposed rule would specifically address standards for timely access to care and States' monitoring and enforcement efforts, reduce burden for some State directed payments and certain quality reporting requirements, add new standards that would apply when States use in lieu of services and settings (ILOSs) to promote effective utilization and specify the scope and nature of ILOS, specify medical loss ratio (MLR) requirements, and establish a quality rating system for Medicaid and CHIP managed care plans. Comments are due by July 3, 2023.
Source: Federal Register
May 2, 2023 - The Centers for Medicare & Medicaid Services (CMS) is seeking comment on an information collection request titled "Patient Provider Dispute Resolution Requirements Related to Surprise Billing: Part II." This information collection request (ICR) focuses on the patient-provider dispute resolution process requirements under the October 7, 2021, interim final rule. Comments are due by July 3, 2023.
Source: Federal Register
May 2, 2023 - Notice from the Centers for Medicare & Medicaid Services (CMS) announcing that in-person delivery of Medicare Diabetes Prevention Program (MDPP) services can be suspended through December 31, 2023. This extension allows MDPP suppliers additional time to resume in-person services as the COVID-19 public health emergency concludes. This notice is effective May 2, 2023.
Source: Federal Register
May 2, 2023 - Describes a study examining financial burdens on rural women cancer survivors, particularly as it relates to insurance type. Patients with public insurance like Medicaid are more likely to feel the burden of basic household needs costs due to reduced ability to work. This is especially problematic for rural residents who are already more likely to have lower incomes and be enrolled in Medicaid.
Source: UAMS News
May 1, 2023 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) regarding changes to the hospital inpatient prospective payment system (IPPS) for operating and capital-related costs of acute care hospitals for fiscal year 2024. Contains details of changes impacting Medicare graduate medical education (GME) for teaching hospitals and inpatient hospital services provided by long-term care hospitals, among other things. This proposed rule also includes information and updates on the Rural Emergency Hospital (REH) designation. Comments are due by June 9, 2023.
Source: Federal Register
May 1, 2023 - Describes the oral healthcare shortages in Florida where 66 of the 67 counties do not have enough dentists to treat all patients. Workforce distribution problems stem from the challenge to recruit dentists to rural areas as well as low Medicaid reimbursement rates. Discusses proposed legislation to improve access to oral healthcare.
Source: KFF Health News, Tampa Bay Times
Apr 30, 2023 - Highlights the expansion of community paramedicine programs while focusing on a particular program in Wyoming. Notes that 55% of community paramedicine programs are located in rural areas. Programs increase access to healthcare by doing home visits, transportation to appointments, and more. Early data show that these programs can increase positive health outcomes and reduce costs for patients. Discusses funding challenges for programs, including coverage by Medicaid and private insurance.
Source: Louisiana Illuminator, KFF Health News
Apr 28, 2023 - The Census Bureau is seeking comment on proposed revisions to the Household Pulse Survey, which helps to inform a range of topics related to households' experiences during the COVID-19 pandemic. Proposed revisions include new detailed race and ethnicity questions, as well as new questions on the use of antivirals to treat COVID, how households obtain COVID tests, the use of infant formula with babies, children's mental health treatment, and pressure to move from current residence. The Census Bureau is also proposing modifications to questions related to children's vaccine booster, COVID testing, infant formula, reasons not working, unemployment insurance, Medicaid, and inflation items. Several questions will be removed for Phase 3.8, including replacing the current race/ethnicity items, and questions about the receipt of updated COVID vaccines, intent to vaccinate children, childcare arrangements, children's mental health and behaviors, and more. Comments are due within 30 days of this notice.
Source: Federal Register
Apr 28, 2023 - The Centers for Medicare & Medicaid Services (CMS) is seeking comment on the following information collections: 1) Implementation of the Medicare Prescription Drug Plan (PDP) and Medicare Advantage (MA) Plan Disenrollment Reasons Survey; 2) Medicare Advantage and Prescription Drug Program: Final Marketing Provisions in 42 CFR 422.111(a)(3) and 423.128(a)(3); 3) Medicaid Drug Rebate Program Labeler Reporting Format; and 4) Testing Experience and Functional Tools (TEFT): Functional Assessment Standardized Items (FASI) Based on the CARE Tool. Comments are due by May 30, 2023.
Source: Federal Register
Apr 27, 2023 - Announcement of the Resident Physician Shortage Reduction Act, proposed legislation to address physician shortages. Legislation would remove the cap on Medicare-funded graduate medical education positions and increase the number of available positions over 7 years. The increase in positions includes prioritization for rural areas and Health Professional Shortage Areas.
Source: Office of Senator Susan Collins
Apr 27, 2023 - Notice of final rule from the U.S. Department of Health and Human Services (HHS) setting parameters for risk adjustment and user fees for state and federal-based exchanges. This rule also addresses requirements for essential community providers and network adequacy, special enrollment periods, income verification, and more. These regulations are effective June 18, 2023.
Source: Federal Register
Apr 26, 2023 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) making several clarifications and updating the definitions used to determine whether a consumer is "lawfully present" in order to be eligible to enroll in a Qualified Health Plan (QHP) through an Exchange; a Basic Health Program (BHP), in states that elect to operate a BHP; and for some state Medicaid and Children's Health Insurance Programs (CHIPs). Among other things, this rule proposes removing the exclusion of Deferred Action for Childhood Arrivals (DACA) recipients from the definitions of "lawfully present" for purposes of eligibility for these insurance affordability programs. Comments are due by June 23, 2023.
Source: Federal Register
Apr 20, 2023 - Announces the release of ownership data for Medicare-certified hospice and home health agencies following an Executive Order from President Biden. Data release will allow anyone to see ownership of more than 6,000 hospices and 11,000 home health agencies. Data includes not just current owner information but also information on mergers and other changes of ownership since 2016. Data will be updated quarterly.
Source: Centers for Medicare & Medicaid Services
Apr 18, 2023 - The Administration for Children and Families, the Centers for Medicare & Medicaid Services, and other federal agencies are working together to recruit partners to help people stay connected to healthcare coverage, by updating contact information and learning what actions are needed to retain healthcare coverage.
Source: Centers for Medicare & Medicaid Services
Apr 18, 2023 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on revisions to the Minimum Data Set 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) for the collection of data related to the Patient-Driven Payment Model and the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP). CMS uses the MDS 3.0 PPS Item Set to collect the data used to reimburse skilled nursing facilities for SNF-level care furnished to Medicare beneficiaries and to collect information for quality measures and standardized patient assessment data under the SNF QRP. Comments are due by May 18, 2023.
Source: Federal Register
Apr 17, 2023 - The Centers for Medicare & Medicaid Services (CMS) is seeking comment on the following information collections: 1) Manufacturer Submission of Average Sales Price (ASP) Data for Medicare Part B Drugs and Biologicals; 2) CAHPS Hospice Survey; 3) Elimination of Cost-Sharing for full benefit dual-eligible Individuals Receiving Home and Community-Based Services; 4) Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices. Comments are due by May 17, 2023.
Source: Federal Register
Apr 17, 2023 - The Centers for Medicare and Medicaid Services announced the 2024 Notice of Benefit and Payment Parameters Final Rule, which finalizes standards for issuers and Marketplaces, as well as requirements for agents, brokers, web-brokers, and Assisters who help consumers with enrollment through Marketplaces that use the federal platform. The rule also builds on the Affordable Care Act by expanding access to quality, affordable health coverage and care and making it easier to select and enroll in health coverage.
Source: Centers for Medicare & Medicaid Services
Apr 14, 2023 - Notice from the Centers for Medicare & Medicaid Services (CMS) announcing the final federal share (FS) Disproportionate Share Hospital (DSH) allotments for fiscal years (FY) 2020 and 2021, and the preliminary FS DSH allotments for FY 2022 and FY 2023. This notice also announces the final FY 2020 and FY 2021 and the preliminary FY 2022 and FY 2023 limitations on aggregate DSH payments that states may make to institutions for mental disease and other mental health facilities. The allotments are effective May 15, 2023.
Source: Federal Register
Apr 14, 2023 - Notice from the Centers for Medicare & Medicaid Services (CMS) announcing its approval of the Accreditation Commission for Health Care (ACHC) for continued recognition as a national accrediting organization for hospitals that wish to participate in the Medicare or Medicaid programs. Comments are due by May 15, 2023.
Source: Federal Register
Apr 14, 2023 - The Centers for Medicare and Medicaid Services (CMS) will hold a virtual public meeting on May 30 - June 1, 2023, to discuss the preliminary coding, Medicare benefit category, and payment determinations for new revisions to the Healthcare Common Procedure Coding System (HCPCS) Level II code set. The agenda and information on how to join the meeting will be posted on the CMS website. Registration is required.
Source: Federal Register
Apr 12, 2023 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) revising regulations for Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE). Revisions include changes related to Star Ratings, health equity, provider directories, coverage criteria, prior authorization, passive enrollment, network adequacy, and other programmatic areas. These regulations are effective June 5, 2023.
Source: Federal Register
Apr 11, 2023 - The Centers for Medicare & Medicaid Services (CMS) is seeking comment on the following information collections: 1) CMS HCPCS Modification to Code Set Form; and 2) Emergency Ambulance Transports and Beneficiary Signature. Comments are due by May 11, 2023.
Source: Federal Register
Apr 11, 2023 - A series of recommendations from an advisory committee to the Secretary of the U.S. Department of Health and Human Services (HHS) for the expansion of Programs of All-Inclusive Care for the Elderly (PACE) could enable elderly residents in rural communities to age in place. Recommendations include expanding telehealth, supporting a program focused on Medicare beneficiaries, allowing PACE sites to be eligible for student loan repayment, and encouraging students trained through the Indian Health Service to rotate to PACE sites.
Source: HealthLeaders Media
Apr 10, 2023 - Notice of proposed rule from the Centers for Medicare and Medicaid Services (CMS) updating the FY 2024 prospective payment rates, outlier threshold, and wage index for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPF), including psychiatric hospitals and excluded psychiatric units of an acute care hospital or Critical Access Hospital. The proposed rule discusses proposals on quality measures and reporting requirements under the Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program, with proposed changes beginning with the FY 2024 payment determination through changes beginning with the FY 2028 payment determination. Comments are due by June 5, 2023.
Source: Federal Register
Apr 10, 2023 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) that would update the skilled nursing facility (SNF) payment rates for fiscal year 2024 and implement the second phase of the Patient-Driven Payment Model (PDPM) parity adjustment recalibration. Includes proposals to update the diagnosis code mappings used under PDPM, the SNF Quality Reporting Program (QRP), and the SNF Value-Based Purchasing (VBP) Program. Comments are due by June 5, 2023.
Source: Federal Register
Apr 10, 2023 - The Georgia state Department of Community Health is using an under-the-radar Medicaid funding mechanism called "directed payments," which is available only for states that hire health insurers to deliver services for Medicaid. The Government Accountability Office and the Medicaid and CHIP Payment and Access Commission (MACPAC) say federal health officials should do more to monitor directed payments and evaluate whether states meet the program's goals.
Source: Kaiser Health News
Apr 7, 2023 - Notice of a proposed rule from the Centers for Medicare and Medicaid Services (CMS) seeking comments on updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2024. Among other things, this proposed rule would rebase and revise the IRF market basket to reflect a 2021 base year, modifies the regulation regarding when IRF units can become excluded and paid under the IRF PPS, and updates the IRF Quality Reporting Program. Includes rural considerations throughout. Comments are due by June 2, 2023.
Source: Federal Register