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Morning Briefing

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Monday, Jul 10 2023

Full Issue

Medicare Plans To Share $9 Billion To 1,600 Previously Underpaid Hospitals

Stat says the more than 1,600 hospitals that participate in a drug discount program will get lump-sum payments after the Supreme Court found they'd been underpaid for prescription drugs. Separately, Stat reports home health providers are suing Medicare over payment cuts set for 2024.

Medicare is planning to send $9 billion in lump-sum payments to more than 1,600 hospitals that participate in a drug discount program after the Supreme Court found the program underpaid them for prescription drugs, the agency announced on Friday. To pay for the restitution, Medicare would slash all hospitals payments for other items and services by 0.5% for the next 16 years. (Cohrs, 7/7)

The National Association of Home Care and Hospice sued the Biden administration to halt the governments recent proposed rule that would cut Medicare payments to home health agencies by 2.2% in 2024. Since 2020, Medicare has updated its system for how it pays for home health, in particular by basing payments less on how much therapy someone is getting at home. By law, the new system cant cost more or less than it otherwise would have, but Medicare reinforced this year that it had paid more under the new system than it would have under the old system and thus continued cuts to home health for next year. (Herman, 7/7)

On Medicaid 'unwinding'

Millions of people are losing Medicaid coverage in the wake of the Covid-19 pandemic. Enrollment in the health program for the low-income and disabled grew to 95 million during the pandemic, as states stopped checking to make sure people were eligible. Now states have started checking again, and more than 1.6 million people have been kicked off the program in the past three months, according to KFF, a health-analysis foundation. Federal regulators estimate that 15 million to 17 million people will eventually be pushed off Medicaid. (Armour, 7/8)

Federal health officials are urging states like Florida to make it easier for people to renew their Medicaid coverage as a mass unwinding following the COVID-19 public health emergency continues. Thousands of Floridians have been disenrolled from Medicaid since the state began redetermining eligibility in May, after a federal directive that states suspend such efforts during the pandemic was lifted. Florida began its process earlier than some others, but committed to spreading out renewals over the course of a year. (Colombini, 7/7)

More than 87,000 Idahoans so far are being removed from Medicaid coverage after expanded coverage from the pandemic has lapsed. A little more than half of Medicaid recipients who lost coverage 48,857 were removed because the Idaho Department of Health and Welfare either could not contact them or the Medicaid enrollees didnt give the agency the information to prove their eligibility, department spokesperson Greg Stahl told the Idaho Capital Sun in an email. Another 38,682 people removed from Medicaid were determined ineligible, Stahl said, while 27,537 were deemed eligible.(Pfannenstiel, 7/10)

Also

A trial court judge has temporarily blocked Mayor Adams from switching retired city workers to a cost-cutting Medicare Advantage Plan. Manhattan Supreme Court Judge Lyle Frank granted a temporary restraining order Thursday that, until he issues a final ruling, prevents roughly 250,000 city retirees and their dependents from losing their current health insurance. (Sommerfeldt and Bamberger, 7/7)

The Philadelphia regions largest health insurer is seeing a dramatic shift in its growth in an increasingly competitive market. Annual revenue at Independence Blue Crosss parent company has grown by an impressive two-thirds over the last five years, adding $10 billion in revenue though 2022. (Brubaker, 7/10)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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