Before the pandemic, telehealth coverage was limited in scope. However, the Centers for Medicare & Medicaid Services (CMS) recently expanded coverage through its regulatory authority and waivers to encourage broad adoption of...more
The Centers for Medicare & Medicaid Services (CMS) released on May 11, 2020, the Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment...more
On the day following the enactment of the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act), the Centers for Medicare & Medicaid Services (CMS) made clear its intention to expand the groups of medical...more
On March 6, Congress passed the Coronavirus Supplemental Appropriations Act (H.R. 6074), which included a $500 million authorization to enhance telehealth services. The legislation gives the U.S. Department of Health and...more
3/25/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Emergency Response ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicaid ,
Medicare ,
OIG ,
Relief Measures ,
Telehealth ,
Telemedicine
The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) on March 9, 2020, released separate but related final rules addressing interoperability,...more
The Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director (SMD) letter and fact sheet on Jan. 30, 2020, that encouraged states to pursue block grant or per capita cap funding through their Medicaid...more
On November 15, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule requiring pricing information to be made publicly available. The 2020 Outpatient Prospective Payment System (OPPS) & Ambulatory...more
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, released the Calendar Year (CY) 2020 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule....more
11/13/2019
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Community Health Systems ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
Rural Health Care Providers ,
Section 340B ,
Transparency
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, published the Calendar Year (CY) 2020 Final Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B,...more
11/11/2019
/ Alternative Payment Models (APM) ,
Ambulance Providers ,
Bundled Payments ,
Centers for Medicare & Medicaid Services (CMS) ,
Drug Treatment ,
Final Rules ,
Health Care Providers ,
Medical Records ,
Medicare ,
Medicare Part B ,
MIPS ,
Open Payments ,
Opioid ,
PHI ,
Physician Fee Schedule ,
Physicians ,
Public Comment ,
Quality Payment Program (QPP) ,
Substance Abuse ,
Telehealth
On August 2, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital Prospective Payment System...more
8/9/2019
/ Applications ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Inpatient Quality Reporting ,
Long Term Care Facilities ,
Medicaid ,
Medicare ,
Payment Systems ,
Proposed Rules ,
Public Comment ,
Rulemaking Process ,
Value-Based Purchasing ,
Wage Index
• The Centers for Medicare & Medicaid Services (CMS) has published the Calendar Year (CY) 2020 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule.
•...more
• The Centers for Medicare & Medicaid Services (CMS) published the Calendar Year (CY) 2020 Proposed Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B, while the...more
8/7/2019
/ Alternative Payment Models (APM) ,
Bipartisan Budget Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Medicare ,
Medicare Shared Savings Program ,
MIPS ,
MPFS ,
Notice of Proposed Rulemaking (NOPR) ,
Physician Fee Schedule ,
Physicians ,
Proposed Rules ,
Telehealth
• The Centers for Medicare & Medicaid Services (CMS) on April 23, 2019, released the Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule.
• The proposed payment rate increase...more
5/1/2019
/ Add-ons ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Fiscal Year ,
Food and Drug Administration (FDA) ,
Graduate Medical Education ,
Health Care Providers ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Inpatient Quality Reporting ,
Long Term Care Facilities ,
Proposed Rules ,
Public Comment ,
Rulemaking Process ,
Value-Based Purchasing ,
Wage Index
The Centers for Medicare & Medicaid Services (CMS) announced five new, voluntary value-based payment models for primary care: Primary Care First and Direct Contracting. Applications are expected to open shortly, and both...more
President Trump's budget was released yesterday as the fiscal year (FY) 2020 appropriations process ramps up. The FY 2020 budget requests $87.1 billion in discretionary funding for the Health and Human Services (HHS)...more
3/14/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Emergency Rooms ,
Federal Budget ,
FQHC ,
Health Care Providers ,
Medicaid ,
Medicare ,
Public Health ,
Trump Administration ,
Veterans Administration
CMS Regulation -
CMS and ONC Unveil Proposals Transforming Interoperability and Patient Access to Data -
The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health...more
3/1/2019
/ 21st Century Cures Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Electronic Health Record Incentives ,
Electronic Protected Health Information (ePHI) ,
Enforcement Actions ,
False Advertising ,
False Claims Act (FCA) ,
Federal Trade Commission (FTC) ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Health Information Technologies ,
Health Insurance Portability and Accountability Act (HIPAA) ,
ONC ,
Opioid ,
Proposed Rules
• The Centers for Medicare & Medicaid Services (CMS) has issued the Calendar Year (CY) 2019 Final Rule that updates payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory...more
11/13/2018
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Data Collection ,
Emergency Rooms ,
Final Rules ,
Health Care Providers ,
Health Clinics ,
Hospitals ,
Medicare ,
Off-Campus Departments ,
Outpatient Prospective Payment System (OPPS) ,
Payment Rates ,
Physician Fee Schedule ,
Physician Medicare Reimbursements ,
Physicians ,
Policies and Procedures ,
Prescription Drugs ,
Section 340B
Healthcare was a top voter priority in the 2018 midterm elections, with 41 percent of national voters stating that healthcare was their "most important" issue. Accordingly, the Democratic strategy to focus on healthcare...more
11/13/2018
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Trump Administration
• The Centers for Medicare & Medicaid Services (CMS) has published the Calendar Year (CY) 2019 Final Rule for the Medicare Physician Fee Schedule (PFS), which includes provisions related to Medicare physician payments as well...more
11/7/2018
/ Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Medicare ,
Medicare Part B ,
MIPS ,
MPFS ,
Pharmaceutical Industry ,
Pharmacies ,
Physician Medicare Reimbursements ,
Physician Payments ,
Physicians ,
Policies and Procedures ,
Prescription Drugs ,
Quality Payment Program (QPP) ,
Telehealth
On Monday, the Centers for Medicare & Medicaid Services (CMS) and the Department of Treasury released guidance relaxing a range of requirements for state waivers submitted under Section 1332 of the Affordable Care Act (ACA)....more
On July 25, 2018, the Centers for Medicare & Medicaid Services (CMS) released proposed policy and payment updates affecting the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC)...more
8/16/2018
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Health Care Providers ,
Health Clinics ,
Hospitals ,
Off-Campus Departments ,
OPPS ,
Outpatient Services ,
Payment Rates ,
Physicians ,
Proposed Rules ,
Public Comment ,
Site-Neutral Exception
On Aug. 9, 2018, Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would update the Medicare Shared Savings Program (MSSP). Called "Pathways to Success," the proposal significantly alters the...more
8/14/2018
/ ACOs ,
Bipartisan Budget Act ,
CEHRT ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
EHR ,
Healthcare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Medicare Shared Savings Program ,
Proposed Regulation ,
Quality Payment Program (QPP)
The Centers for Medicare & Medicaid Services (CMS) on July 12, 2018, published the CY 2019 Proposed Rule for the Medicare Physician Fee Schedule (PFS). While in previous years regulations for the Quality Payment Program (QPP)...more
7/23/2018
/ Alternative Payment Models (APM) ,
Bi-Partison Balanced Budget Act (BBA) ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Health Care Providers ,
Medicare ,
Medicare Part B ,
MIPS ,
Outpatient Services ,
Pharmaceutical Industry ,
Physician Fee Schedule ,
Physicians ,
Proposed Rules ,
Public Comment ,
Quality Payment Program (QPP) ,
Reporting Requirements ,
Telehealth
On Feb. 9, 2018, Congress passed and President Donald Trump signed into law the Bipartisan Budget Act of 2018 (BBA). This wide-reaching legislation enacts major changes for telehealth policy in Medicare by incorporating...more
4/17/2018
/ Bi-Partison Balanced Budget Act (BBA) ,
Centers for Medicare & Medicaid Services (CMS) ,
DEA ,
Department of Health and Human Services (HHS) ,
ESRD ,
FQHC ,
Health Care Providers ,
Health Information Technologies ,
HELP Act ,
Home Health Care ,
Medicare ,
Medicare Advantage ,
OIG ,
Physician Fee Schedule ,
Prescription Drugs ,
Ryan Haight Act ,
Telehealth ,
Telemedicine ,
Ways and Means Committee
On Feb. 9, 2018, the Trump Administration released a 30-page report analyzing domestic and global factors influencing drug pricing. The report by the Council of Economic Advisers (CEA) is expected to inform the HHS' Fiscal...more
2/13/2018
/ Antitrust Provisions ,
Biosimilars ,
Budget Reconciliation ,
Centers for Medicare & Medicaid Services (CMS) ,
Commodity Exchange Act (CEA) ,
Cross-Border Transactions ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Federal Budget ,
Fixed Price ,
Food and Drug Administration (FDA) ,
GAO ,
Health Care Providers ,
Incentives ,
Manufacturers ,
Medicaid ,
Medicare ,
Medicare Part B ,
Medicare Part D ,
MedPAC ,
OIG ,
Outpatient Services ,
Pharmaceutical Industry ,
Physician Medicare Reimbursements ,
Prescription Drugs ,
Price-Fixing ,
Rebates ,
Secretary of HHS ,
Section 340B ,
Social Security Act ,
Supply Chain ,
Trump Administration