News & Analysis as of

Medicare Office of Management and Budget

McDermott+

Hospitals, Take Note: CMS Adopts Changes to Medicare Rural Designations

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Under Medicare, a plethora of policies directly correlate to whether the patient or provider is located in an urban or rural area when the service is delivered. These policies range from rules that limit coverage of...more

Akin Gump Strauss Hauer & Feld LLP

The Regulatory Race Is On: The Biden Administration Sprints to Issue Key Health Policies

The upcoming election, and the approaching end of the President’s four-year term, introduce additional dynamics into the agencies’ rulemaking process and even the guidance process. From now through the November election, the...more

King & Spalding

CMS Issues Hospice Proposed Payment Rule

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Last week, CMS issued a proposed rule (Proposed Rule) for fiscal year (FY) 2025 aiming to update Medicare hospice payments and aggregate cap amount in accordance with existing statutory and regulatory requirements. The...more

Holland & Knight LLP

Holland & Knight Health Dose: April 9, 2024

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

Mintz

Mintz IRA Update — Demystifying the IRA’s Small Biotech Exception

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On August 29, 2023, CMS selected the first 10 high-expenditure, single source, Medicare Part D drugs subject to negotiation under the IRA’s Medicare Drug Price Negotiation Program (the “Negotiation Program” or “Program”). In...more

McDermott+

Regs During an Election Year: What’s on the Menu?

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Last week, McDermott+Consulting launched an election 2024 resource page, where you can find a 2024 health policy outlook and other insights into the November election. While regulations aren’t necessarily top-of-mind when...more

McDermott+

McDermottPlus Check-Up: January 5, 2024

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Congress Returns Next Week to Face Imminent Funding Deadlines. The Senate will return to session on January 8, and the House will return on January 9. Lawmakers face an immediate time crunch on FY 2024 appropriations, as the...more

Holland & Knight LLP

Holland & Knight Health Dose: December 12, 2023

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

Wiley Rein LLP

The IRA’s Negotiation Process ICR and Revised Negotiation Program Guidance

Wiley Rein LLP on

On July 25, 2023, the Centers for Medicare & Medicaid Services (CMS) republished its Drug Price Negotiation Process Information Collection Request (Negotiation Process ICR). The Negotiation Process ICR, which was originally...more

Polsinelli

Fall Congressional Forecast: Eye on Federal Funding and Health Care

Polsinelli on

Congress faces a crowded agenda this fall comprised of must-pass policy initiatives and potential political messaging opportunities in the lead up to the November midterm elections. With control of both chambers at stake, the...more

Latham & Watkins LLP

Healthcare & Life Sciences: Drug Pricing Digest - May 2021 #2

Latham & Watkins LLP on

PhRMA Suit Challenges Co-Pay/Accumulator Portion of December 2020 Medicaid Rule - On May 21, 2021, Pharmaceutical Research and Manufacturers of America (PhRMA) filed suit in the US District Court for the District of...more

ArentFox Schiff

Senate Finance Committee Holds Confirmation Hearing For Top Biden HHS Nominees

ArentFox Schiff on

Deputy Secretary and CMS Administrator Picks Would Fill Two Critical Policy Positions - On Thursday, the Senate Finance Committee held a confirmation hearing for two of the most important health policy officials nominated...more

McGuireWoods Consulting

Washington Healthcare Update - March 2021 #5

Congress - House - Representatives Propose a Permanent Extension of CHIP Funding - The House Energy and Commerce Committee is looking at ways to strengthen the Affordable Care Act (ACA) and expand Medicaid coverage. A...more

McGuireWoods Consulting

Senate Acts to Avert Medicare Sequester Payment Reductions — House Needs to Act

In the nick of time, the U.S. Senate passed legislation on March 25, 2021, to delay a 2 percent across-the-board cut to Medicare through the rest of 2021. The vote was 90 to 2. Without the delay, all Medicare providers would...more

McGuireWoods Consulting

Washington Healthcare Update - November 2020 #1

McGuireWoods Consulting on

This week in Washington: Washington’s focus has been on the presidential and Senate races....more

King & Spalding

CMS Final Rule Updates Medicare Payment Rates and Quality Programs for SNFs

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On July 31, 2020, CMS issued Final Rule CMS-1737-F for fiscal year 2021, in its yearly update to Medicare payment policies for SNFs (the Final Rule). In addition to updating Medicare payment rates under the SNF prospective...more

King & Spalding

CMS Releases Tools to Support States’ Medicaid and CHIP Programs During the COVID-19 Outbreak

King & Spalding on

On March 22, 2020, CMS announced a suite of four new tools intended to help states combat the coronavirus by allowing states to streamline enrollment into long-term care and home-based services and by expediting application...more

McDermott Will & Emery

CMS Advances 340B Drug Acquisition Cost Survey to OMB and Solicits Final Comments Directly to OMB

McDermott Will & Emery on

On February 7, 2020, the Centers for Medicare and Medicaid Service (CMS) published a notice signaling that it has submitted its previously published September 2019 proposed survey of hospital 340B drug costs for Office of...more

Health Care Compliance Association (HCCA)

CMS Rules: Direct Supervision Is Gone, Prior Auth Is Here; Documentation Fix Has Limits

Report on Medicare Compliance 28, no. 40 (November 11, 2019) - CMS has given the green light to prior authorization for five types of procedures in an attempt to control “unnecessary increases” in these procedures as part...more

McGuireWoods Consulting

Washington Healthcare Update - October 2019 #1

This week in Washington: The House and Senate are in recess. Congress House Senate Administration Proposed Regulations/Guidance Final Rules/Guidance Reports House Bipartisan Legislation Introduced on Accurate Provider...more

McGuireWoods Consulting

Washington Healthcare Update April 2019 #3

Congress - Hearings/Markups - Senate Finance Committee: "Drug Pricing in America: A Prescription for Change, Part III" - Tuesday, April 9, 2019: The Senate Finance Committee continued its drug pricing series by...more

McGuireWoods Consulting

Washington Healthcare Update March 2019 #1

Upcoming Hearings - Tuesday, March 5, 2019 - Senate Committee on Health, Education, Labor and Pensions (HELP): “Vaccines Save Lives: What is Driving Preventable Disease Outbreaks?” - The Senate Committee on Health,...more

McGuireWoods Consulting

Washington Healthcare Update February 2019 #3

Upcoming Hearings - Tuesday, Feb. 26, 2019 - Senate Finance Committee: “TBA Hearing on Drug Pricing” - The second hearing in a series on drug pricing in the Senate Finance Committee will include the testimonies of...more

McGuireWoods Consulting

Washington Healthcare Update

McGuireWoods Consulting on

Congress - House - Bipartisan, Bicameral Legislators Unveil FDA-Inspired Bill Regulating Diagnostic Tests - On Dec. 6, bipartisan House and Senate members released draft legislation for the Food and Drug...more

McGuireWoods Consulting

Washington Healthcare Update

McGuireWoods Consulting on

Congress - House - Likely New Health Leadership - With the change in control of the House of Representatives in the next Congress, there will be “new” faces leading the health care agenda....more

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