Billy Wynne

Commissioners Support Annual Inflation-Based Update for Physician Payment; Will Make Recommendations to Improve Payment Accuracy The Medicare Payment Advisory Commission (MedPAC) convened a session to discuss a policy option to update Medicare physician fee schedule (PFS) rates as well as an option to improve the accuracy of these rates. Principal Policy Analysts Brian O’Donnell and Geoff Gerhardt reviewed…

Commissioners Examine MA-PD and PDP Markets; Discuss MA-PD Structural Advantages and Market Dynamics The Medicare Payment Advisory Commission (MedPAC) convened a session on structural differences between the Part D standalone prescription drug plan (PDP) and the Medicare Advantage prescription drug plan (MA-PD) markets. In the presentation, Senior Analyst Tara Hayes and Principal Policy Analysts Shinobu…

Agency Finalizes Estimated Payment Increase of 2.7 Percent to ESRD Facilities in CY2025 The Centers for Medicare & Medicaid Services (CMS) released its calendar year (CY) 2025 end-stage renal disease (ESRD) prospective payment system (PPS) final rule (fact sheet). Details follow. What it is. This final rule outlines ESRD PPS payment policies applying to dialysis…

Commissioners Examine Interview and Focus Group Findings on Transitions of Care for Children and Youth with Special Health Care Needs The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session focused on the challenges of transitions of care for children and youth with special health care needs (CYSHCN) as they move from pediatric…

CY 2025 MPFS Final Rule Cuts Payment by 2.93%, Includes New Coding and Payment for an Array of Services The Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2025 Medicare Physician Fee Schedule (MPFS) final rule (fact sheet; MSSP fact sheet), which addresses a wide range of reimbursement-related policies under Medicare…

Agency Finalizes 2.9 Percent Increase for CY 2025 OPPS Payments The Centers for Medicare and Medicaid Services (CMS) released the Calendar Year (CY) 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule (press release, fact sheet). What it is. CMS’ wide-ranging final rule affects payments to approximately 3,500…

MACPAC Convenes Panel to Discuss State Medicaid and CHIP Continuous Eligibility Approaches The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a panel to discuss policies and considerations for state Medicaid and CHIP multi-year continuous eligibility (CE) approaches. The session started with a quick background of CE and its goal to mitigate churn, which…

MACPAC Examines Residential Treatment for Medicaid-Enrolled Youth The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session to examine how Medicaid facilitates access to intensive residential services for children and youth with serious behavioral health conditions. This session aimed to deepen the Commission’s understanding of barriers to appropriate access to these services. Staff…

FNS Finalizes Rule to Improve Access and Parity in Food Distribution Programs The Department of Agriculture (USDA) Food and Nutrition Service (FNS) released a final rule to improve access and parity in food distribution programs (final rule; press release). Impacted programs include the Commodity Supplemental Food Program (CFSP), Food Distribution Program on Indian Reservations (FDPIR), The Emergency…

Proposed Information Collection Request for Medicare Transaction Facilitator Data Transmission Released; Comments Due December 27 The Centers for Medicare and Medicaid Services (CMS) released an information collection request (ICR) on the Medicare Transaction Facilitator (MTF) to be used in 2026 and 2027 in the Medicare Drug Price Negotiation Program. What is it. The notice indicates…