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Reps. Smith and Dingell Introduce Bipartisan Bill to Expand Medicare Care at Home Options

Reps. Smith and Dingell Introduce Bipartisan Bill to Expand Medicare Care at Home Options

Congressman Adrian Smith (R-NE) and Congresswoman Debbie Dingell (D-MI) have introduced the 'Bringing Rehabilitation, Integrated Delivery, and Greater Extended (BRIDGE) Care at Home Act.' This bipartisan bill aims to modernize Medicare by allowing beneficiaries to receive skilled nursing and rehabilitation services in their homes after a qualifying hospital stay. The proposed legislation would establish a five-year Medicare 'SNF-at-Home' pilot program. This program would enable the Department of Health and Human Services Secretary to compare the costs, outcomes, and patient characteristics of home-based care versus facility-based care. Supporters of the bill view it as a means to expand patient choice, alleviate pressure on hospitals and nursing facilities, and potentially reduce healthcare costs.

Representatives Smith and Dingell Introduce Bipartisan BRIDGE Care at Home Act to Expand Home Healthcare Services

Representatives Smith and Dingell Introduce Bipartisan BRIDGE Care at Home Act to Expand Home Healthcare Services

Representatives Adrian Smith (R-NE) and Debbie Dingell (D-MI) have jointly introduced the BRIDGE Care at Home Act. This bipartisan legislation aims to broaden healthcare options by allowing skilled nursing and intensive rehabilitation services to be delivered in patients' homes. The initiative builds upon the success of the 'Hospital at Home' model, seeking to provide an alternative to traditional facility-based care. The proposed act will establish a framework to evaluate whether eligible Medicare beneficiaries can safely receive these services at home, while also assessing the impact on readmission rates, patient functional status, satisfaction levels, and the costs associated with providing skilled nursing facility care in a home setting compared to inpatient care. This move is designed to offer patients greater choice in their recovery environment, support family caregivers, and create new opportunities for healthcare professionals to deliver care outside institutional settings.

Abe Sutton Appointed Director of Center for Medicare and Medicaid Innovation

Abe Sutton Appointed Director of Center for Medicare and Medicaid Innovation

Abe Sutton has been appointed as the Director of the Center for Medicare and Medicaid Innovation and Deputy Administrator for the Centers for Medicare and Medicaid Services (CMS). He assumed these roles in January 2025. Prior to this appointment, Sutton co-founded two health service companies: Honest Health, which focuses on supporting primary care physicians, and Evergreen Nephrology, which aims to empower nephrologists. Sutton has a background in federal health policy, having served with the federal government from 2017 to 2019. During his previous tenure, he worked at the National Economic Council, Domestic Policy Council, and the Department of Health and Human Services. In these capacities, he was responsible for coordinating health policy across the federal government, with a particular focus on transitioning Medicare to a value-based payment system, enhancing choice and competition within healthcare markets, and modernizing the federal government's approach to kidney care.

Dr. Wesley Smith Informs Federal Remote Patient Monitoring Regulations and Medicare Shift to Value-Based Care

Dr. Wesley Smith Informs Federal Remote Patient Monitoring Regulations and Medicare Shift to Value-Based Care

Dr. Wesley Smith, a clinical associate professor at the University of Miami School of Education and Human Development, is actively involved in shaping federal regulations and payment models for remote patient monitoring. He recently engaged with the Office of Management and Budget (OMB) during the final stages of federal rulemaking concerning remote patient monitoring within the Medicare Physician Fee Schedule. The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) also participated in this discussion. The OMB, HHS, and the House Ways and Means Committee are currently considering a shift in Medicare's payment structure towards value-based care, which would compensate for patient outcomes, such as reduced blood pressure or avoided hospitalizations, rather than for individual visits, time spent, or device readings. Dr. Smith advocates for longitudinal remote care as a practical method to achieve value-based care, emphasizing the crucial role of consistent cli...

Humana Seeks Medicare Field Sales Representatives in North Houston to Expand Market Reach

Humana Seeks Medicare Field Sales Representatives in North Houston to Expand Market Reach

Humana Seeks Medicare Field Sales Representatives in North Houston to Expand Market Reach

Senator Cassidy Aide Announces Forthcoming Legislation to Reform No Surprises Act

Senator Cassidy Aide Announces Forthcoming Legislation to Reform No Surprises Act

Senator Bill Cassidy, R-La., a key author of the No Surprises Act (NSA), is preparing to release new legislation aimed at reforming the law, according to his health policy advisor, Romney Gripado. The NSA, enacted in 2020, was designed to protect patients from unexpected medical bills. While successful in this regard, it has faced criticism from both insurers and providers. Insurers argue that providers are exploiting the law's payment resolution process to secure inflated awards, often aided by supposedly independent arbiters. Conversely, providers claim insurers are delaying or withholding payments. Cassidy's proposed bill seeks to address these issues by strengthening program integrity, improving oversight of arbiters, restoring accountability, and increasing transparency in the dispute resolution process. The legislation also aims to protect employers from unnecessary costs, ensure timely compensation for providers, and tackle incentives that may be driving increased arbitration utilization. This initi...

CMS Finalizes 2027 Medicare Physician Payment Cuts and Policy Reforms

CMS Finalizes 2027 Medicare Physician Payment Cuts and Policy Reforms

The Centers for Medicare & Medicaid Services (CMS) has released its Medicare Physician Fee Schedule, finalizing significant payment cuts and policy reforms for 2027. Physicians participating in qualifying Advanced Alternative Payment Models (APMs) will face a conversion factor cut of -1.83%, while those not in qualifying APMs will see a larger reduction of -2.31%. These cuts are primarily driven by the expiration of a temporary 2.5% payment increase provided by Congress for 2026. Additionally, CMS is continuing its multi-year trend of reforming Medicare payments, including changes to evaluation and management (E/M) reimbursements and practice expense methodology. A notable change is the reduction in reimbursements for separately identifiable E/M visits furnished on the same day as a 0-day global procedure. CMS also announced that the traditional Merit-based Incentive Payment System (MIPS) will end in 2030, requiring physicians to transition to MIPS Value Pathways (MVPs) by 2031. Furthermore, new restrictio...

Humana Seeks Medicare Field Sales Agents in Milford, PA to Expand Market Reach

Humana Seeks Medicare Field Sales Agents in Milford, PA to Expand Market Reach

Humana Seeks Medicare Field Sales Agents in Milford, PA to Expand Market Reach

Department of Health and Human Services Seeks Health Insurance Specialist for Medicare Payment Policy

Department of Health and Human Services Seeks Health Insurance Specialist for Medicare Payment Policy

The Department of Health and Human Services (HHS), specifically the Centers for Medicare & Medicaid Services (CMS), Center for Medicare, is actively recruiting for a Health Insurance Specialist, GS-0107-15. This position is based in Woodlawn, MD, and offers a salary range of $169,279 to $197,200 per year. The specialist will serve as an expert in providing technical policy advice for Original Medicare Payment Policy programs. Key responsibilities include leading the development of regulatory changes and legislative proposals related to Medicare. The application period is open until November 19, 2026, with telework eligibility determined by agency policy. Applicants are required to complete online assessments as part of the application process.

Democrats are weighing impeachment of RFK Jr. while courting his supporters

Democrats are weighing impeachment of RFK Jr. while courting his supporters

When Democrats take over Congress in January, Health Secretary Robert F. Kennedy Jr. will be a major oversight target

Humana Seeks Medicare Field Sales Representatives in South Houston to Expand Market Presence

Humana Seeks Medicare Field Sales Representatives in South Houston to Expand Market Presence

Humana Seeks Medicare Field Sales Representatives in South Houston to Expand Market Presence

Representatives Smith and Dingell Introduce Bipartisan Bill to Modernize Medicare and Expand Home Care Options

Representatives Smith and Dingell Introduce Bipartisan Bill to Modernize Medicare and Expand Home Care Options

Congressman Adrian Smith (R-NE) and Congresswoman Debbie Dingell (D-MI) have introduced the Bringing Rehabilitation, Integrated Delivery, and Greater Extended (BRIDGE) Care at Home Act. This bipartisan legislation aims to modernize Medicare by creating a five-year pilot program that allows beneficiaries to receive skilled nursing services in their homes following a qualifying hospital stay. Currently, Medicare covers skilled nursing care only in facilities, leading to a shortage of beds and extended hospital stays for patients awaiting post-hospital care. The bill seeks to address these capacity issues and provide patients with more choices for their recovery, aligning with the preference of many patients to receive care at home. The proposed pilot program would also direct the Department of Health and Human Services Secretary to evaluate the quality, outcomes, costs, and patient characteristics of home-based skilled nursing care compared to facility-based care over its five-year duration.