Department Launches Whistleblower Portal to Report Gender-Affirming Care Providers; Issues Accompanying Legal Guidance to Navigate HIPAA Privacy Protections

Department Launches Whistleblower Portal to Report Gender-Affirming Care Providers; Issues Accompanying Legal Guidance to Navigate HIPAA Privacy Protections

The Department of Health and Human Services (HHS) announced new actions to protect whistleblowers who report concerns regarding the use of chemical and surgical gender-transition procedures on minors. This includes the release of legal guidance and the launch of a whistleblower complaint portal. Additionally, HHS’ Office for Civil Rights (OCR) initiated its first conscience rights investigation into an unnamed major… (Colocho, April 16, 2025) #Health Equity, #Pediatrics, #Privacy, #Public Health

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President Trump Issues Memorandum Directing the Repeal of Unlawful Regulations Without Public Notice-and-Comment

President Trump Issues Memorandum Directing the Repeal of Unlawful Regulations Without Public Notice-and-Comment

President Trump issued a Presidential Memorandum titled “Directing the Repeal of Unlawful Regulations”, expanding on the deregulatory initiative set forth in Executive Order 14219 (issued February 19, 2025). The memorandum commands all executive departments and agencies to: Immediately begin repealing any regulation identified as unlawful or exceeding statutory authority, especially those conflicting with recent Supreme Court precedents. Bypass the typical… (Colocho, April 15, 2025) #Costs

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Commission Examines Access to Hospice and High-Cost Services under the Hospice Benefit for Beneficiaries with End-Stage Renal Disease and Cancer

Commission Examines Access to Hospice and High-Cost Services under the Hospice Benefit for Beneficiaries with End-Stage Renal Disease and Cancer

The Medicare Payment Advisory Committee (MedPAC) convened a session to examine access to hospice and specific high-cost services, such as dialysis, blood transfusions, radiation, and chemotherapy, for beneficiaries with end-stage renal disease (ESRD) and cancer under the Medicare hospice benefit. The session was prompted by concerns raised in the Centers for Medicare and Medicaid Services’ (CMS) proposed hospice rules for… (Colocho, April 14, 2025) #Accountable Care Organizations, #Costs, #End of Life and Palliative Care, #End-Stage Renal Disease, #Hospice

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Agency Proposes 2.4 Percent Payment Increase for Hospices in FY 2026 and Includes RFIs on Barriers to Interoperability and Future Quality Measures Concepts; Comments due June 10

Agency Proposes 2.4 Percent Payment Increase for Hospices in FY 2026 and Includes RFIs on Barriers to Interoperability and Future Quality Measures Concepts; Comments due June 10

The Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2026 hospice payment rate update proposed rule (fact sheet). What it is. The proposed rule addresses the hospice wage index, payment rates, and aggregate cap amount for FY 2026, along with updates from the hospice quality reporting program. Why it’s important for you. CMS proposes a 2.4… (Colocho, April 14, 2025) #End of Life and Palliative Care, #Health Equity, #Hospice, #Nutrition, #Wellness

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FY 2026 IPPS and LTCH PPS Rule Proposes 2.4 Percent Overall Increase for Hospitals and Changes to TEAM; Solicits Input on Deregulation

FY 2026 IPPS and LTCH PPS Rule Proposes 2.4 Percent Overall Increase for Hospitals and Changes to TEAM; Solicits Input on Deregulation

The Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2026 inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) proposed rule (fact sheet), which applies to acute care hospital and LTCH payments beginning Oct. 1, 2025. Under the proposed rule, acute care hospitals would receive a 2.4 percent increase ($4 billion including the… (Testa, April 11, 2025) #Critical Access Hospitals, #Demonstration Programs, #Disproportionate Share Hospitals (DSH), #Hospitals, #Long-Term Care Hospitals, #Nutrition, #Quality, #Readmissions, #Workforce

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Panel Explores Benefits and Risks of AI in Medicaid Prior Authorization

Panel Explores Benefits and Risks of AI in Medicaid Prior Authorization

The Medicaid and CHIP Payment and Access Commission (MACPAC) held a panel session focused on the use of automation and artificial intelligence (AI) in the Medicaid prior authorization process. The discussion explored how these technologies are currently being implemented, their potential to improve efficiency, and the implications for payers, providers, and beneficiaries. Panelists included Dr. Sanmi Koyejo of Stanford University,… (Colocho, April 11, 2025) #Health Information Technology

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Commissioners Discuss the Value of MA Supplemental Benefits; Emphasize Data Limitations and Consider Modifications

Commissioners Discuss the Value of MA Supplemental Benefits; Emphasize Data Limitations and Consider Modifications

The Medicare Payment Advisory Committee (MedPAC) convened a session to assess the utilization and delivery of supplemental benefits in Medicare Advantage (MA). This meeting followed a session in October focused on the background and plan financing of supplemental benefits (Impact summary). The staff presentation highlighted that it is difficult to assess the value provided by spending on supplemental benefits because of the limitations… (McClurg, April 11, 2025) #Medicare Advantage

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Commission Continues Work on Long-Stay Nursing with Review of Quality Policies

Commission Continues Work on Long-Stay Nursing with Review of Quality Policies

Today, the Medicare Payment Advisory Committee (MedPAC) convened its third session this cycle about the long-stay nursing home population. The Commission previously reviewed its workplan for the topic in October (Impact summary) and discussed Institutional Special Needs Plans (I-SNPs) in March (Impact summary). Today’s session focused on long-standing concerns about the quality of care this population receives in nursing homes…. (Testa, April 11, 2025) #Long-Term Care, #Quality, #Readmissions, #Skilled Nursing Facilities, #Workforce

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Commissioners Review Draft Chapter on the Program of All-Inclusive Care for the Elderly (PACE) and Discuss Potential Areas for Work

Commissioners Review Draft Chapter on the Program of All-Inclusive Care for the Elderly (PACE) and Discuss Potential Areas for Work

The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session to review a draft chapter for the June 2025 Report to Congress on the Program of All-Inclusive Care for the Elderly (PACE) – a fully integrated Medicare-Medicaid program that serves adults ages 55 and older with nursing facility level of care needs while allowing them to live in… (Llamas, April 10, 2025) #Dual Eligibles

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Agency Issues Press Release Detailing Dr. Oz’s Vision After Recent Town Hall

Agency Issues Press Release Detailing Dr. Oz’s Vision After Recent Town Hall

CMS issued a press release describing the new Administrator for the Center for Medicare & Medicaid’s vision and his role in the “Make America Healthy Again” agenda. The release describes a focus on modernizing Medicare, the Marketplaces, and Medicaid, including empowering Americans with personalized health solutions and greater cost transparency, as directed by the President’s Executive Order. Under Dr. Mehmet Oz’s leadership, CMS… (Testa, April 10, 2025) #Chronic Diseases, #Costs, #Nutrition, #Prevention, #Program Integrity, #Transparency, #Wellness

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