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 Inpatient Rehabilitation Facility Prospective Payment System Final Rule
On July 27, the Centers for Medicare & Medicaid Services (CMS) issued the federal fiscal year (FFY) inpatient rehabilitation facility (IRF) prospective payment system (PPS) final rule. CMS estimates that total payments to IRFs in FFY 2024 will increase by 4% ($355 million) compared with 2023.
CMS Issues Inpatient Psychiatric Facility Prospective Payment System Final Rule
On July 27, the Centers for Medicare & Medicaid Services (CMS) issued the federal fiscal year (FFY) inpatient psychiatric facility (IPF) prospective payment system (PPS) final rule. CMS estimates that in FFY 2024, total payments to IPFs will increase by 2.3% ($70 million) compared with 2023. This is an increase from the 1.9% ($55 million) that was recommended in the proposed rule.
CHA Responds to Senate Request for Information on 340B Program
CHA submitted comments in response to a bipartisan request from six U.S. senators seeking information on the 340B Drug Pricing Program. In the letter, CHA shared information to underscore the importance of the 340B program in maintaining access to health care for individuals who live in rural and underserved communities.
CMS Issues Final Payment and Policy Updates for Inpatient Rehabilitation Facilities and Inpatient Psychiatric Facilities
The Centers for Medicare & Medicaid Services has issued the federal fiscal year (FFY) 2024 inpatient rehabilitation facility prospective payment system (PPS) and inpatient psychiatric facility PPS final rules. The policy and payment provisions in the final rules are effective for FFY 2024 discharges, beginning Oct. 1. CHA is reviewing the regulations and will provide […]
Proposed Rule Would Require Mental Health Parity for Health Plans
The departments of the Treasury, Labor, and Health and Human Services have released a proposed rule to improve access to mental health services by requiring health plans to make changes when inadequate access is provided. The proposed rule reinforces the Mental Health Parity and Addiction Equity Act of 2008, which requires health plans to ensure […]
CHA Issues Summary of CY 2024 Physician Fee Schedule Proposed Rule, Specialty Tables
CHA has issued a three-part, members-only summary and specialty impact analysis, prepared by Health Policy Alternatives, Inc. (HPA), of the calendar year 2024 physician fee schedule (PFS) proposed rule. Comments are due to the Centers for Medicare & Medicaid Services by 2 p.m. (PT) on Sept. 11.
CMS Issues a Request for Information Related to Episodic Payment Models
On July 14, the Centers for Medicare & Medicaid Services (CMS) issued a request for information (RFI) related to episodic payment models. In the RFI, CMS notes its interest in developing payment models that will create additional opportunities for specialists to participate in models that facilitate “accountable care relationships” with Medicare beneficiaries. The agency believes this step is necessary to achieve its goal of having 100% of Medicare beneficiaries in an accountable care relationship by 2030.
CMS Issues CY 2024 Physician Fee Schedule Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) has issued its calendar year (CY) 2024 proposed rule for the physician fee schedule (PFS). In addition to updating physician payments, the rule creates new billable services that support caregivers and the provision of whole person care. The rule also makes additional changes to the Medicare Shared Savings Program (MSSP).
CMS Issues CY 2024 OPPS Proposed Rule
On July 13, the Centers for Medicare and Medicaid Services (CMS) issued its calendar year (CY) 2024 outpatient prospective payment system (OPPS) proposed rule. CMS estimates that Medicare expenditures under OPPS will increase by $6 billion relative to estimated current year payments based on changes in the proposed rule.
CHA Issues Summary of CY 2024 ESRD PPS Proposed Rule
CHA has issued a members-only summary, prepared by Health Policy Alternatives, Inc., of the calendar year (CY) 2024 end-stage renal disease (ESRD) prospective payment system (PPS) proposed rule.