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Native American participation in medical research

Disparities in Native American health are well documented. American Indians (AI) and Alaskan Natives (AN) have higher rates of diabetes and heart disease than other Americans and an average life expectancy ten years shorter than the U.S. average. Despite these critical issues, AI/AN populations continue to be significantly underrepresented in biomedical research—even for treatments for conditions which disproportionately impact them. A variety of [...] Read More

Discarded drug policy moves forward

As Applied Policy reported in January, under Section 90004 of Infrastructure Investment and Jobs Act (Infrastructure Act) which was passed in November 2021, manufacturers of drugs, including biosimilar biologic products, in single dose container or single use packages which are separately payable under Medicare Part B are required to provide the Centers for Medicare & Medicaid Services [...] Read More

HHS proposes rule to protect people with disabilities

On September 7th, the U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), issued the Discrimination on the Basis of Disability in Health and Human Service Programs or Activities proposed rule. HHS also issued a Fact Sheet and press release on the proposed changes. The goal of the rule [...] Read More

MedPAC holds September 2023 meeting

On September 7 and 8, 2023, the Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting. The meeting included the following sessions: Context for Medicare payment policy; Medicare Advantage: MedPAC workplan; Standardized benefits in Medicare Advantage plans; Improving MedPAC’s estimate of Medicare Advantage coding intensity; Medicare’s Acute Care Hospital at Home program; and Ambulatory [...] Read More

Current challenges in risk adjustment

As the United States transitions from a fee-for-service (FFS) model of healthcare delivery to value-based payments (VBP), both payers and providers have recognized the importance of fairly accounting for preexisting differences in patient health status. The management of heart disease in a patient with diabetes and high blood pressure is inherently more complex and consequently [...] Read More

CMS proposes minimum staffing requirements for long term care (LTC) facilities

On September 1st, the Centers for Medicare & Medicaid Services (CMS) issued the long-awaited Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting proposed rule. As part of the Biden Administration’s Nursing Home Reform initiative, this rule includes proposals to establish national minimum nurse staffing standards to ensure safe and high-quality [...] Read More

AI at HHS

The Department of Health and Human Services piqued interest last month with notification that its case use inventory for artificial intelligence (AI) had tripled in the last year. HHS's listed cases uses point to how its agencies hope to leverage AI’s potential while navigating federal policies, stakeholder skepticism, and technological challenges.  HHS's 2023 inventory, publication [...] Read More

CMS Finalizes FY 2024 Inpatient Payment Policies for Hospitals, Changing Payment Rates, Limiting Physician-Owned Hospital Expansion Criteria, and Finalizing Quality Reporting Changes

On August 1, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2024 Hospital Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals and the Long-Term Care Hospital (LTCH) Prospective Payment System and Counting Certain Days Associated with Section 1115 Demonstrations in the Medicaid Fraction final rules. See the press release [...] Read More

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