About Medicare
The federal Medicare program is an essential pillar of the state’s health care system, supporting more than 6 million Californians over the age of 65 and younger Californians with disabilities. One in five hospitals is at risk of closing, in part because Medicare reimbursement rates are far lower than the cost of providing care. It’s essential that future federal Medicare policy protects patient care.
CMS Issues Post-Acute Care Payment Proposed Rules
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued its proposed payment policies for inpatient rehabilitation facilities (IRFs), skilled-nursing facilities (SNFs), and hospices for federal fiscal year (FFY) 2025.
What else to know: Comments on the proposed rules are due to CMS by 2 p.m. (PT) on May 28.
CMS Issues FFY 2025 Inpatient Psychiatric Facility PPS Proposed Rule
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued its federal fiscal year (FFY) 2025 inpatient psychiatric facility (IPF) prospective payment system (PPS) proposed rule.
What else to know: Comments are due to CMS by 2 p.m. (PT) on May 28.
Medicare Reduces Coinsurance Amount for 41 Different Part B Drugs
What’s happening: Medicare temporarily reduced the coinsurance amount for 41 different Part B prescription drugs under the Inflation Reduction Act.
What else to know: Through June 30, the coinsurance amount is decreased from 20% to between 3.8% and 19.9%, depending on the drug.
CY 2025 Medicare Advantage, Part D Payment Changes Finalized
What’s happening: The Centers for Medicare & Medicaid Services (CMS) finalized changes to Medicare Advantage (MA) Part C and Part D payments for calendar year (CY) 2025.
What else to know: Comments on the MA data request for information are due by May 29. The policies are effective Jan. 1, 2025.
MedPAC to Develop Rural Hospital and Clinician Payment Workplan
What’s happening: The Medicare Payment Advisory Commission (MedPAC) is developing a rural hospital and clinician payment policy workplan for 2024–25.
What else to know: The March MedPAC meeting included discussion to inform a future recommendation to Congress related to rural hospitals.
CHA Supports Bill to Train More Doctors to Address Opioid and Substance Use Epidemic
What’s happening: The Substance Use Disorder Workforce Act (H.R. 7050) was introduced in the U.S. House of Representatives.
What else to know: CHA is part of a coalition supporting this legislation.
CMS Announces New Primary Care Payment Model
What’s happening: The Centers for Medicare & Medicaid Services (CMS) announced the Accountable Care Organization (ACO) Primary Care (PC) Flex Model, a new voluntary payment model that will test how prospective payments and increased funding for primary care in ACOs impact health outcomes, quality, and costs of care.
What else to know: CMS will launch the model on Jan. 1, 2025.
CHA Summary: Proposed Changes for Oversight of Accrediting Organizations
What’s happening: CHA is sharing its summary of the Centers for Medicare & Medicaid Services’ (CMS) proposed rule intended to strengthen oversight of accrediting organizations (AOs) such as The Joint Commission and Det Norske Veritas.
What else to know: While the proposed policies are applicable to AOs, several proposed changes will affect hospitals and health systems that rely on AO accreditation.
AHA to Host Annual Meeting April 14-16 in Washington, D.C.
What’s happening: Hospital leaders from around the country will convene in Washington, D.C. on April 14-16 for the American Hospital Association’s (AHA) Annual Membership Meeting.
What else to know: CHA encourages AHA members to register for this event.
President Biden Releases FY 2025 Budget Request
What’s happening: President Biden submitted his fiscal year (FY) 2025 budget request to Congress.
What else to know: The budget is a blueprint of the administration’s priorities and is not legislation.