Jeffrey Davis on Physician Fee Schedule

Regulatory Implications of the Continuing Resolution Healthcare Package

Earlier this week, Congress released the text of a continuing resolution that includes a more-robust-than-anticipated healthcare package. While the bill’s primary purpose is to keep the government open through March 14, 2025,...more

12/19/2024 / Centers for Medicare & Medicaid Services (CMS) , Children's Health Insurance Program (CHIP) , Congressional Committees , Healthcare , Legislative Agendas , Medicaid , Medicare , Medicare Access and CHIP Reauthorization (MACRA) , MIPS , Pharmaceutical Industry , Physician Fee Schedule , Proposed Legislation , Regulatory Agenda , Regulatory Reform , Telehealth , Telemedicine

Another Trip to the Buffet: Highlights from the CY 2025 OPPS Final Reg

As mentioned last week, the Centers for Medicare & Medicaid Services (CMS) recently put out a large buffet of regs – too many to digest in one blog post. While we focused on the Calendar Year (CY) 2025 Physician Fee Schedule...more

11/14/2024 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Healthcare , Healthcare Reform , Legislative Agendas , Medicare , New Regulations , Outpatient Prospective Payment System (OPPS) , Pharmaceutical Industry , Physician Fee Schedule , Regulatory Agenda , Telemedicine

Digesting the Huge Buffet of CMS Regs: Highlights from the CY 2025 PFS Final Reg

While we all are focused on the election results, let’s take a quick break to digest some regs and eggs. The Centers for Medicare & Medicaid Services (CMS) “spoiled” all of us in the health policy world with a huge buffet of...more

11/7/2024 / Centers for Medicare & Medicaid Services (CMS) , Final Rules , Health Care Providers , Healthcare , Healthcare Reform , Medicare , Medicare Shared Savings Program , Mental Health , MIPS , New Regulations , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Telehealth

CMS Releases CY 2025 Physician Fee Schedule Final Rule

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2025 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more

11/6/2024 / Centers for Medicare & Medicaid Services (CMS) , Final Rules , Health Care Providers , Hospitals , Medicare , MIPS , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Physicians

Responses to the PFS Proposed Reg Are In: 10 Major Comments

McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. Click here to subscribe to future blog posts. September 19, 2024 – Comments on the calendar year (CY) 2025 physician fee...more

9/19/2024 / Centers for Medicare & Medicaid Services (CMS) , Comment Period , Health Care Providers , Healthcare , Healthcare Reform , Medical Coding , Medicare , MIPS , Physician Fee Schedule , Proposed Regulation , Telemedicine

Legislative Uncertainty Slows Down, But Doesn’t Halt, Regulatory Action on Telehealth and Digital Health

Legislative Uncertainty on Telehealth Waivers Slows Down, But Doesn’t Halt, Regulatory Action on Virtual Care McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. Click here to...more

8/1/2024 / Centers for Medicare & Medicaid Services (CMS) , Healthcare , Healthcare Reform , Legislative Agendas , Medicare Part B , Physician Fee Schedule , Proposed Legislation , Rulemaking Process , Telehealth , Telemedicine

CMS Proposes New CoP for Obstetrical Services: With Great Power Comes Great Responsibility

In case you need a reminder given everything going on in Washington, DC, the Calendar Year (CY) 2025 Physician Fee Schedule (PFS) and CY 2025 Outpatient Prospective Payment System (OPPS) proposed regs were released a couple...more

7/25/2024 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Healthcare , Healthcare Reform , Medicare , New Regulations , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Popular , Regulatory Agenda

The Budget Neutrality Paradox: Explaining the CY 2025 PFS Positive Budget Neutrality Adjustment

The major calendar year proposed regs are now out, with thousands of pages of text to digest. Since a plethora of issues are embedded in these regs, including the Calendar Year (CY) 2025 Physician Fee Schedule (PFS) and the...more

7/18/2024 / Centers for Medicare & Medicaid Services (CMS) , Federal Budget , Healthcare , Legislative Agendas , Medical Billing Codes , New Legislation , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Vaccinations

CMS Releases CY 2025 Physician Fee Schedule Proposed Rule

On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more

7/17/2024 / Centers for Medicare & Medicaid Services (CMS) , Medicare , MIPS , Physician Fee Schedule , Physicians , Telehealth

“Reg Season” is Coming! Preview of the Physician Fee Schedule

School is out and it is summertime, which means only one thing in the health policy community: reg season! This is the time of the year when the Centers for Medicare & Medicaid Services (CMS) releases regulations that propose...more

6/19/2024 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Healthcare , Healthcare Reform , Medicare , MIPS , New Regulations , Physician Fee Schedule , Physicians , Regulatory Agenda , Telehealth

2022 Quality Payment Program Performance Report Released: Observations and Insights

A couple of weeks ago, the Centers for Medicare & Medicaid Services (CMS) released an important report that provides insight into a significant contributor of clinicians’ overall Medicare reimbursement for this year....more

5/23/2024 / Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Legislative Agendas , MIPS , New Legislation , Physician Fee Schedule , Quality Payment Program (QPP) , Regulatory Agenda , Regulatory Reform

President Biden Releases FY 2025 Budget: What’s NOT in It?

Earlier this week, President Biden released his Fiscal Year (FY) 2025 President’s Budget. As a reminder, every year, the White House releases a budget that serves as its official funding request to Congress for the following...more

3/14/2024 / Artificial Intelligence , Biden Administration , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Executive Orders , Federal Budget , Healthcare , Medicaid , Medicare , Medicare Advantage , Medicare Part A , Medicare Part B , MedPAC , Mental Health , Pharmacy Benefit Manager (PBM) , Physician Fee Schedule , Public Health Emergency , Transparency

No Congressional Doc Fix on the Immediate Horizon: What Happens Next?

Congress is on its way to extending the stop-gap funding bills into March (and may have already done so by the time you read this). Absent from the legislation to continue funding the federal government is a “doc fix” that...more

1/18/2024 / Centers for Medicare & Medicaid Services (CMS) , Congressional Committees , Health Care Providers , Healthcare , Healthcare Reform , Legislative Agendas , MACs , Medicare , MPFS , Physician Fee Schedule , Proposed Legislation

Looking Forward: Top Policy Areas for 2024

Happy New Year! As we enter 2024, we want to lay out some of the main regulatory issues (both new and old) that McDermott+Consulting will be tracking over the next year. While these may evolve, we think they are still...more

Regulatory Reflections from the Past Year

As 2023 comes to a close, I can’t help but reflect on all the regulations and policies we reviewed this year (and those that we’ll continue to handle next week before the year actually ends). There were some tasty eggs with...more

12/21/2023 / Centers for Medicare & Medicaid Services (CMS) , Consolidated Appropriations Act (CAA) , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Drug Pricing , Health Care Providers , Healthcare , Healthcare Reform , Legislative Agendas , No Surprises Act (NSA) , Physician Fee Schedule , Public Health Emergency , Regulatory Agenda , Telehealth

REGS & TURKEY LEGS: The Regs We’re Thankful For

It’s Thanksgiving week, so instead of eating eggs with your regs, you should sit back, relax and reflect on the regs you are thankful for as you eat your turkey legs (or whatever you enjoy on Thanksgiving). Many of the...more

11/21/2023 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Digital Health , Final Rules , Healthcare , Healthcare Reform , Inpatient Prospective Payment System (IPPS) , Medicare , Mental Health , New Legislation , New Regulations , No Surprises Act (NSA) , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Regulatory Agenda , Telehealth

The Major Regs Are Out! Will Congress Intervene in of the “Final” Policies?

A few weeks ago, Regs & Eggs discussed the constant give and take between federal agencies and Congress as they both work on overlapping policies and objectives. The major regs released last week provide an excellent example...more

11/9/2023 / Centers for Medicare & Medicaid Services (CMS) , Congressional Committees , Healthcare , Healthcare Reform , Legislative Agendas , New Legislation , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Price Transparency , Proposed Legislation , Senate Committees , Telehealth , U.S. House

Policy Update - CMS Releases CY 2024 Physician Fee Schedule Final Rule

On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2024 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more

11/7/2023 / Centers for Medicare & Medicaid Services (CMS) , Final Rules , Health Care Providers , Medicare , Medicare Part B , Physician Fee Schedule , Physicians , Quality Payment Program (QPP) , Reimbursements , Telehealth

SPECIAL EDITION: It’s a Regs & Eggs Buffet—Scrambled, Over Easy, Fried, Soft and Hard-Boiled

Hungry for some Regs & Eggs? Well, you are in luck, because this week, the Regs & Eggs buffet is open, with your choice of eggs made any style. Enough regs were released this week to feed an entire family—and the...more

11/3/2023 / Centers for Medicare & Medicaid Services (CMS) , Final Rules , Health Care Providers , Healthcare , Healthcare Reform , Medicare , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Physicians , Proposed Regulation , Regulatory Reform , Section 340B

Previewing the Final Hospital Outpatient Medicare Payment Reg

Sharpen your pencils and locate your reading glasses: the final Medicare payment regulations for calendar year (CY) 2024 will be released within the next week. In the last Regs & Eggs blog post, I discussed a major issue...more

10/26/2023 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Drug Pricing , Health Care Providers , Hospitals , Medicare , Medicare Part B , Outpatient Prospective Payment System (OPPS) , Outpatient Services , Physician Fee Schedule , Price Transparency , Regulatory Agenda , Regulatory Requirements , Section 340B

7/27/2023 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Inpatient Billing , Medicare , Outpatient Prospective Payment System (OPPS) , Outpatient Services , Payment Systems , Pharmaceutical Industry , Physician Fee Schedule , Price Transparency , Section 340B

Jeffrey Davis

McDermott Will & Emery

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