The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) released a report on challenges meeting the Medicaid payer of last resort requirement. In general, if a Medicaid enrollee has another source of health care coverage, that source should pay the full extent of its liability before Medicaid pays, which is referred to as third-party liability (TPL)…. (McClurg, October 31, 2023) #Program Integrity

The Senate Health, Education, Labor, and Pensions (HELP) Committee convened a ‘field hearing’ to examine the issue of nurse staffing ratios. Senate HELP Chair, Bernie Sanders, visited New Jersey to address the labor dispute involving approximately 1,700 striking nurses at Robert Wood Johnson University Hospital, one of the state’s largest health systems. Chair Sanders, the only senator in attendance, reiterated… (Colocho, October 30, 2023) #Hospitals, #Workforce

Today, the Departments of Health and Human Services, Labor, and the Treasury (the Departments) and the Office of Personnel Management issued a proposed rule on regulations governing the Federal Independent Dispute Resolution (IDR) process under the No Surprises Act (fact sheet).   What it is. The Departments propose an array of changes to improve communication and information exchange and promote… (Llamas, Slifer, Colocho, October 27, 2023) #Hospitals, #Insurance Reform, #Physicians

The Centers for Medicare & Medicaid Services (CMS) released its calendar year (CY) 2024 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 facilities beginning on or after Jan. 1, 2024. The rule also includes an update to acute kidney injury… (Marceno, October 27, 2023) #Coverage Decisions, #End-Stage Renal Disease

The Cybersecurity and Infrastructure Security Agency (CISA) and the Department of Health and Human Services (HHS) jointly released a cybersecurity toolkit tailored for the U.S. health care and public health (HPH) sector to address the growing cybersecurity challenges faced by health care organizations. CISA noted that health care organizations are increasingly vulnerable to cyberattacks as they rely on digital technologies… (Colocho, October 26, 2023) #Health Information Technology, #Hospitals

Through the Administration for Children and Families (ACF), the Department of Health and Human Services (HHS) announced almost $3.7 billion in funding for the Low Income Home Energy Assistance Program (LIHEAP) to provide financial assistance to help cover the cost of energy for homes. Through the LIHEAP program, the federal government disburses financial resources to states, tribes, and territories to… (Gravesande, Marceno, October 25, 2023) #Health Equity, #Prevention, #Public Health

The Department of Agriculture (USDA) Food and Nutrition Service (FNS) released a report on household food security in 2022. FNS collects this data to analyze the level of food security and inform its nutrition assistance programs. The report found that in 2022, an estimated 87.2 percent of U.S. households were food secure, meaning that all household members had access at all… (McClurg, October 25, 2023) #Nutrition

The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) released a report to determine whether the Assistant Secretary for Preparedness and Response (ASPR) Strategic National Stockpile (SNS) was effective in responding to the COVID-19 pandemic. The SNS is a repository of vaccines, antibiotics, antidotes, antitoxins, medical devices, supplies, and medications to supplement and resupply public… (McClurg, October 23, 2023) #COVID-19, #Public Health

The House Energy & Commerce (E&C) Health Subcommittee convened a hearing to discuss a wide array of proposals to increase physician payment, increase access to care, and reduce administrative burden. Members spoke with two panels which included representatives from the Administration, physicians, the Medicare Payment Advisory Commission (MedPAC), and think tanks. This hearing was the first to examine physician payment… (McClurg, October 20, 2023) #Costs, #Delivery Reform, #Geographic Variation, #Health Information Technology, #Medicare Access and Chip Reauthorization Act of 2015 (MACRA), #Physicians, #Quality

The Senate Budget Committee convened a hearing to examine ways to improve health care delivery and reduce federal health care spending in the budget. Chairman Sheldon Whitehouse (D-RI) intended for the hearing to set the foundation to move bipartisan legislation. Members discussed primary care and accountable care organizations, prior authorization, transparency requirements, all-payers claims database, and other topics. The witness… (Llamas, October 18, 2023) #Hospitals, #Physicians