Mar 27, 2018 | Physician Fee Schedule
The Secretary of HHS is statutorily given the authority to periodically revise and revalue RVUs (relative value units) at least every 5 years for all of the codes established under the physician fee schedule (PFS). In this brief, we will provide an overview of the review process and ook at a few examples of reviews that have occurred in the past several years – a few of which resulted in cuts of 20% or more. Click to read more.
Mar 22, 2018 | Medicare, MedPAC, Part D, Payers
On March 15, the Medicare Payment Advisory Commission (MedPAC) released its March 2018 Report to Congress assessing Medicare payment policy. The report includes analyses of payment adequacy in fee-for-service (FFS) Medicare, reviews the status of Medicare Advantage (MA) and the prescription drug benefit (Part D), and includes a mandated report on telehealth in Medicare. This brief includes all of MedPAC’s recommendations submitted to Congress as part of the report. Click to read more
Mar 21, 2018 | Behavioral, Hospitals, IDD, Medicaid
In March, the Medicaid and CHIP Payment and Access Commission (MACPAC) continued its conversation on the substance use disorder treatment continuum of care and IMD exclusion. The commission also discussed tailoring managed long-term services and supports (MLTSS) programs for individuals with intellectual and developmental disabilities (IDD), along with the role of Medicaid base and supplemental payments to hospitals. Click to read more.
Mar 21, 2018 | Legislation/ Budgets/ Macro
HHS actuaries project US spending on healthcare will increase by 1 percentage point faster than GDP from 2017 to 2026, rising to 19.7% of GDP by 2026 from 17.9% in 2016.Click to read more.
Mar 20, 2018 | Medicaid, Medicaid Managed Care, Medicare Advantage
A recent CMS report observed enrollment trends in managed care from 2006 through 2016 and found that the proportion of dual eligibles in managed care had tripled. In this brief, we’ll highlight the report’s findings and use CMS data to examine characteristics of the dual beneficiary population. Click to read more.
