CMS Proposes Hospital Pay Hike For 2026
Under the proposed rule for fiscal 2026, Medicare reimbursements for inpatient hospital care would rise 2.4%. Reimbursements for long-term care hospitals would rise 2.6%, and nursing home reimbursements would rise 2.8%. Other Medicare and Medicaid news is on pricey bandages, provider taxes, and more.
Modern Healthcare:
Hospitals To See Medicare Rate Increase For 2026 In CMS Proposal
Medicare reimbursements for inpatient hospital care would increase 2.4% in fiscal 2026 under a proposed rule the Centers for Medicare and Medicaid Services published Friday. Long-term care hospitals would get a 2.6% pay hike under the same draft regulation. A separate rule issued Friday calls for a 2.4% boost to inpatient psychiatric facility rates next fiscal year, which begins Oct. 1. (Early, 4/11)
Modern Healthcare:
Nursing Homes Could See 2.8% Medicare Pay Increase In 2026
Skilled nursing homes would receive a 2.8% payment bump in fiscal 2026 under a proposed rule the Centers for Medicare and Medicaid Services announced late Friday. MS said the proposed rate increase includes a market basket update of 3%, a 0.6% market basket forecast error adjustment and a cut of 0.8% due to a productivity adjustment. The proposed pay hike is far below the 4.2% pay increase CMS gave nursing homes in fiscal 2025. (Eastabrook, 4/11)
In other Medicare news —
MedPage Today:
MedPAC: Medicare Paid MA Plans $38 Billion For Non-Medicare Services In 2024
Last year, Medicare Advantage (MA) plans spent $38 billion on services traditional Medicare doesn't pay for, such as gym memberships, meals, transportation, and dental care. But a report presented to the Medicare Payment Advisory Commission (MedPAC) Thursday lamented the agency's inability to evaluate the value of those services, to what extent beneficiaries actually used them, and with which companies the plans contract to provide them. (Clark, 4/11)
The New York Times:
Trump Administration Delays Plan To Limit Pricey Bandages
The Trump administration announced Friday it would delay the implementation of a Biden-era rule meant to restrict coverage of unproven and costly bandages known as skin substitutes. The policy will be delayed until 2026, allowing companies to continue setting high prices for new products, taking advantage of a loophole in Medicare rules. The companies sell those bandages at a discount to doctors, who then charge Medicare the full sticker price and pocket the difference, The New York Times reported on Thursday. (Kliff and Thomas, 4/11)
In Medicaid developments —
Modern Healthcare:
CMS To End Medicaid Designated State Health, Investment Programs
The Centers for Medicare and Medicaid Services is cutting off funding for initiatives designed to address health-related social needs for Medicaid enrollees, the agency notified states in a letter Thursday. So-called designated state health programs and designated state investment programs currently in operation under 1115 waivers may continue, but CMS will not extend them nor approve new applications, Center for Medicaid Director Drew Snyder wrote in a letter to state officials. (Early, 4/11)
The Wall Street Journal:
The $600 Billion Medicaid Maneuver On The Chopping Block
An obscure set of state taxes on hospitals and other health providers is in the crosshairs of congressional budget cutters because the levies can lead to higher federal spending on Medicaid. Known as provider taxes because states impose them on hospitals, nursing homes and other facilities that provide healthcare, the taxes boost a state’s budget for funding Medicaid. That in turn attracts more matching federal dollars to fund the program—money that is ultimately directed back to the hospitals and clinics. (Walker, 4/14)
The Hill:
Johnson: GOP Medicaid Cuts Will Target People Not 'Eligible'
House Speaker Mike Johnson (R-La.) said Sunday that Republicans would protect entitlement programs as they press ahead with deep cuts to federal spending, but he added the government must “eliminate people on Medicaid” who are not “eligible to be there.” “The president has made absolutely clear many times, as we have as well, that we’re going to protect Medicare, Social Security, Medicaid, for people who are legally beneficiaries of those programs,” Johnson told Maria Bartiromo on Fox News’s “Sunday Morning Futures.” (Suter, 4/13)
