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.
Access to Mental Health Services Could Increase for Medicare Advantage Enrollees
What’s happening: The Centers for Medicare & Medicaid Services (CMS) proposes policy changes for Medicare Advantage (MA) plans in contract year (CY) 2025.
What else to know: Comments on the proposed rule, which addresses MA policies such as prior authorization, outpatient behavioral health and supplemental benefits, are due Jan. 5.
CMS Finalizes Inadequate Outpatient Payment Update
What’s happening: The Centers for Medicare & Medicaid Services (CMS) has finalized the calendar year (CY) 2024 outpatient prospective payment system rule.
What else to know: It includes a net market basket update of 3.1%, which is a slight increase over the proposed 2.8%.
Final Home Health Rule Reduces Impact of Behavioral Adjustments on Providers
What’s happening: The Centers for Medicare & Medicaid Services (CMS) has issued the final rule for the home health prospective payment system for calendar year 2024.
What else to know: Medicare payments to home health agencies will increase in the aggregate by 0.8% instead of the 2.2% decrease that was originally proposed.
Certain 340B Hospitals to Receive Lump-Sum Settlement
What’s happening: A final rule from the Centers for Medicare & Medicaid Services (CMS) contains a remedy for the agency’s 340B-acquired drug payment policy that was in effect from 2018 to 2022.
What else to know: Eligible hospitals will receive a lump-sum settlement for claims, including beneficiary cost sharing, as a result of CMS’ invalidated policy that reduced payments for separately payable outpatient drugs acquired under the 340B program.
Area Wage Index Litigation
This page contains important, members-only information related to the Centers for Medicare & Medicaid Services’ recently finalized area wage index policy. To continue, please log in to your member account.
Payments to Renal Disease Facilities Increasing for 2024
What’s happening: The Centers for Medicare & Medicaid Services’ final rule details the end-stage renal disease prospective payment system for calendar year 2024.
What else to know: The base rate will increase to $271.02.
Federal Medicaid Proposed Regulations Webinar
CHA is hosting a webinar featuring Chad Mulvany, Vice President of Federal Policy, and Robert Ducay, Vice President of Policy. Both experts will discuss their insights and potential impacts related to these proposals. They will answer any questions you have about these proposed rules.
CMS Finalizes Policies for 2024 Medicare Advantage and Part D Programs
The Centers for Medicare & Medicaid Services (CMS) has finalized changes to Medicare Advantage (MA) and Part D programs for contract year 2024. The final rule is effective June 5.
Overview of Changes to the Medicare BPCI-A Payment Model — Participant Information
CMS recently announced the extension of the Bundled Payments for Care Improvement Advanced (BPCI-A) model. Join us for this informative webinar as experts provide an overview of the model, including updates for 2024 participation, application considerations, and program details. Organizations that have never applied for BPCI-A, as well as current BPCI-A participants, will benefit from […]