Senate Finance Committee Chair Ron Wyden (D-OR) released a report on the Committee’s investigation into eight hospitals that reportedly denied or delayed emergency reproductive health for pregnant women in potential violation of the Emergency Medical Treatment and Active Labor Act (EMTALA) post-Dobbs (press release). Chair’s Recommendations Recognizing that the incoming Trump-Vance administration is likely to reverse federal guidance issued in 2022… (Llamas, December 20, 2024) #Women’s Health

Sens. Bill Cassidy (R-LA), Catherine Cortez Masto (D-NV), John Cornyn (R-TX), and Michael Bennet (D-CO) released draft legislation (section-by-section; press release) to improve the Medicare Graduate Medical Education (GME) program and provide new residency slots. What it is. This draft legislation follows the Senate Medicare GME Working Group’s policy framework and request for information released in May of this year. Why it’s important for you. The draft bill… (McClurg, December 19, 2024) #Graduate Medical Education (GME)

The Centers for Medicare and Medicaid Services (CMS) Office of the Actuary (OACT) recently released the National Health Expenditures 2023 Estimates, providing a detailed look into U.S. healthcare spending (infographic). In 2023, total health spending reached $4.9 trillion, marking a 7.5% increase from the previous year, outpacing the slower growth rates seen in 2021 and 2022. This rise was primarily… (Eisen, December 19, 2024) #Budget, #Costs, #COVID-19, #Hospitals, #Physicians

The Center for Medicare & Medicaid Innovation (CMMI/Innovation Center) announced four state Medicaid agencies, Michigan, New York, Oklahoma, and South Carolina, have been selected for the Innovation in Behavioral Health Model (IHPP Summary). The purpose of the IBH Model is to assist participating practices in enhancing access to and promoting high-quality integrated care. Oklahoma has elected to run its model… (Marceno, December 18, 2024) #Mental and Behavioral Health, #Opioids, #Prevention

The Centers for Medicare and Medicaid Services (CMS) released the draft Medicare Transaction Facilitator (MTF) agreements, which outline the responsibilities of each party that will be engaged in the MTF. CMS provides the following draft agreements for the relevant parties: The Manufacturer-CMS Agreement The Manufacturer-MTF Data Module Contractor Agreement The Manufacturer-MTF Payment Module Contractor Agreement The Dispensing Entity-CMS Agreement The… (Slifer, December 18, 2024) #Prescription Drugs

On December 12-13, the Medicare Payment Advisory Commission (MedPAC) held a public meeting at which it considered a series of draft payment update recommendations to Medicare payment systems in 2026 for inclusion in its March 2025 Report to Congress. The Commission expressed support for 2026 draft payment recommendations to increase payments to acute care hospitals and providers and to establish… (Testa, December 13, 2024) #Costs, #Home Health, #Hospice, #Hospitals, #Inpatient Rehabilitation Facilities, #Long-Term Care Hospitals, #Post-Acute Care, #Skilled Nursing Facilities

The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session focused on self-directed services in Medicaid Home- and Community-Based Services (HCBS), which allow individuals with long-term care needs to live independently in their communities. Self-direction is an HCBS delivery model that allows the individual choice in their service provider(s) and control over the amount, duration, and scope of… (Colocho, Eisen, December 13, 2024) #Care Coordination, #Home Health

Recently, the Department of Health and Human Services (HHS) issued a final rule to adopt updated versions of the retail pharmacy standards for electronic transactions adopted under the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HHS details that adoption of the updated versions will provide improvements, such as more robust data exchange, improved… (Slifer, December 13, 2024) #Pharmacies

The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session focused on the tools available to states to ensure accountability when setting up contracts with Medicaid managed care organizations (MCOs). The presentation introduced this new topic of work for the Commission, establishing that MACPAC is interested in understanding the Centers for Medicare & Medicaid Services’ (CMS’) regulatory role… (Marceno, December 12, 2024) #Delivery Reform, #Program Integrity, #Quality

The Department of Health and Human Services (HHS), through the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP), released the Health Data, Technology, and Interoperability: Trusted Exchange Framework and Common Agreement (TEFCA) final rule (HTI-2 final rule) (press release). What is it. The rule finalizes only the TEFCA portion of what was originally in the HTI-2 proposed… (McClurg, December 11, 2024) #Health Information Technology