(March 24, 2023) – MedPAC Releases 2023 Report to Congress
The Medicare Payment Advisory Commission released the 2023 annual report to Congress, which contains the following notable information.
- Including COVID-19 provider relief payments, inpatient prospective payment system hospitals' all-payer operating margin reached 8.7 percent for 2021.
- Including COVID-19 provider relief payments, IPPS hospital Medicare margins increased to -6.2 percent in 2021. Excluding the provider relief payments, the Medicare margins would decrease to -8.3 percent.
- MedPAC projects hospitals' Medicare margins in 2023 will be lower than in 2021, estimating it will decrease to -10 percent.
- MedPAC anticipates the fiscal year 2024 update to hospital payment rates of current law plus 1 percent would be adequate to maintain fee-for-service beneficiary access to inpatient and outpatient PPS care.
HHS Announces Guidance for Medicare Drug Price Negotiations Program and Reduced Coinsurance
The U.S. Department of Health and Human Services released initial guidance for the Medicare Drug Price Negotiation Program for 2026. The Inflation Reduction Act provided Medicare the ability to negotiate lower prescription drug prices in an attempt to lower drug costs. The Centers for Medicare & Medicaid Services provided additional information about reduced coinsurance for certain Part B drugs, effective Saturday, April 1. "For the quarter April 1 – June 30, 2023, people with Medicare may experience coinsurance amounts that are lower than what they would have paid before the new law passed by as much as $2 to $390 per average dose."
Kaiser Reports on State's Preparation for Medicaid Eligibility Reverifications
The Kaiser Family Foundation issued a report on states' efforts to prepare for the "Medicaid unwinding" and the reverification of Medicaid eligibility for all participants. Reverification begins Saturday, April 1, and continues through June 2024.
Before You Go ...
- The Medicaid and Children's Health Insurance Program Payment and Access Commission's annual report to Congress includes analyses and recommendations for improving race and ethnicity data collection, improving transparency in nursing facility reimbursements and changes to covered prescription drugs. It also includes the annual analysis on state disproportionate share hospital allotments and payments.