Medicaid Reimbursement

Over 40% of Hospitals Seeing Bad Debt, Uncompensated Care Increase

by Jacqueline LaPointe

A new survey of hospital executives and finance leaders has found that bad debt, uncompensated care, and self-pay patients have all gone up since the start of the pandemic, adding to other revenue and...

CMS Makes COVID-19 Data Reporting a Condition of Participation

by Jacqueline LaPointe

COVID-19 data reporting will no longer be voluntary for hospitals participating in Medicare and Medicaid programs, according to a new interim final rule from CMS. For more coronavirus updates, visit...

Medicaid Enrollment Grew by 2.3M People at Start of the Pandemic

by Jacqueline LaPointe

In the first several months of the COVID-19 pandemic, Medicaid enrollment increased by at least 2.3 million Americans, according to researchers from the University of Minnesota. For more coronavirus...

Provider Relief Fund Deadline Extended for Medicaid Providers

by Jacqueline LaPointe

HHS recently announced that it extended the deadline for Medicaid providers and plans to apply for $15 billion in Phase 2 general distribution payments from the Provider Relief Fund. For more...

Medicaid Alternative Payment Model Reduces Imaging, Costs

by Jacqueline LaPointe

A Medicaid alternative payment model in Oregon reduced utilization of imaging and other traditional primary care services among community health centers by about 42 percent, according to an Oregon...

TX Hospitals to Receive $1B Boost in Medicaid Reimbursement

by Jacqueline LaPointe

The gap between what hospitals actually spend to treat Medicaid patients and the Medicaid reimbursement amount for that care will get about $1 billion smaller in 2021. Texas Governor Greg Abbott...

1 in 5 Adults Reporting Job, Coverage Disruption Now Uninsured

by Jacqueline LaPointe

COVID-19 led to an uptick in the number of uninsured individuals as companies furloughed or laid off staff to make ends meet. Many of these workers and their families lost coverage as a...

Skilled Nursing Facilities Facing a Financial Crisis from COVID-19

by Jacqueline LaPointe

Skilled nursing facilities are on the verge of collapsing due to historic underfunding and the financial repercussion of the COVID-19 crisis, according to a new report from the American Health Care...

HHS Releases $15B in Coronavirus Relief to Medicaid Providers

by Jacqueline LaPointe

Medicaid providers and safety-net hospitals are getting a larger slice of coronavirus relief funds after several calls from industry leaders for HHS to allocate more emergency payments to the...

Providers Ask Congress for Financial Assistance to Combat COVID-19

by Jacqueline LaPointe

Leading provider groups are calling on the federal government to protect them from financial losses stemming from the COVID-19 outbreak to ensure frontline providers have the supplies, infrastructure,...

Key Waivers, Regulatory Flexibility for Providers During COVID-19

by Jacqueline LaPointe

President Trump declared the COVID-19 outbreak a national emergency last week in a move that will allow HHS to enact 1135 waivers and regulatory flexibilities to help hospitals activate emergency...

Trump Budget Eyes More Site-Neutral, Hospital Reimbursement Cuts

by Jacqueline LaPointe

President Trump’s proposed budget for the 2021 fiscal year (FY) is stirring up controversy over massive cuts to Medicare and Medicaid spending and proposals to implement work requirements and...

CO Healthcare Costs Keep Climbing Due to Hospital Cost-Shifting

by Jacqueline LaPointe

Hospital cost-shifting is behind rising healthcare costs in Colorado, according to a new report from the state’s Department of Health Care Policy & Financing. The report found that, despite...

Funding Legislation Delays $4B in Medicaid DSH Payment Cuts

by Jacqueline LaPointe

Funding legislation aimed at keeping HHS and other non-Defense agencies running in fiscal year (FY) 2020 will also postpone $4 billion in Medicaid Disproportionate Share Hospital (DSH) payment cuts...

CMS Looks to Tighten Medicaid Supplemental Payment Arrangements

by Jacqueline LaPointe

A rule proposed by CMS on Tuesday would enable greater transparency and oversight of Medicaid supplemental payments to providers, which have proliferated in the last couple of years. The Medicaid...

Adjusting Medicaid Payments for Social Determinants to Boost Care

by Samantha McGrail

Adjusting Medicaid payments for social determinants of health would help address the broader social needs of children and cost restraints at safety-net hospitals, according to researchers from the...

More States Require Value-Based Reimbursement in Medicaid

by Samantha McGrail

The number of states with Medicaid managed care requiring value-based reimbursement as part of the public healthcare program increased from 22 out of 39 states in 2017 to 28 out of 40 states by 2019, a...

CMS Finalizes How It Will Cut Medicaid DSH Payments Starting Oct 1

by Jacqueline LaPointe

Update 9/27/2019: The Senate passed a continuing resolution that would temporarily stop the implementation of Medicaid DSH payment cuts until Nov. 22, 2019.  CMS on Monday finalized a rule...

Public Charge Rule to Boost Uncompensated Care Costs, Hospitals Say

by Jacqueline LaPointe

The American Hospital Association (AHA) and five other hospital groups urged a court on Wednesday to stop a Department of Homeland Security final rule that is likely to reduce the number of insured...

NY Medicaid Program Bringing Value-Based Payment to Pediatrics

by Jacqueline LaPointe

New York is overcoming the challenges of developing value-based payment models for pediatrics to bring value to the approximately 1.8 million children enrolled in its Medicaid program, according to a...