News & Analysis as of

Consolidated Appropriations Act (CAA) Final Rules

Verrill

Final Mental Health Parity Rule Spells Compliance Changes

Verrill on

The long-anticipated final rule under the Mental Health Parity and Addiction Equity Act (MHPAEA) was published on September 9, 2024. The MHPAEA prohibits group health plans that provide mental health and substance use...more

Bricker Graydon LLP

Mental Health Parity and Addiction Equity Act (MHPAEA) Final Regulations Have Been Issued

Bricker Graydon LLP on

If you are a state or local government that sponsors a “self-funded” employee group health plan instead of using an insurance provider, you had previously been allowed to “opt out” of compliance with the following four...more

Foley & Lardner LLP

Final Mental Health Parity Rules – Top Five Changes to the Status Quo

Foley & Lardner LLP on

The Mental Health Parity and Addiction Equity Act and its implementing regulations and guidance (MHPAEA) prohibit health insurance policies and group health plans that cover mental health and substance use disorder (MH/SUD)...more

King & Spalding

CMS Publishes FY 2025 Inpatient Psychiatric Facilities Prospective Payment System and Quality Reporting Updates Final Rule

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On July 31, 2024, CMS published a final rule updating the Medicare rates and policies applicable to inpatient psychiatric facilities (IPFs) under the IPF Prospective Payment System (PPS) and the IPF Quality Reporting Program...more

Mintz - Health Care Viewpoints

CMS Publishes Final Rules Implementing Part C and Part D Program Changes

On April 23, 2024, the Centers for Medicare & Medicaid Services (CMS) published final rules setting forth Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Program for Contract Year 2024--Remaining...more

King & Spalding

CMS Issues Final Rule Changing Medicaid DSH Third-Party Payor Rule

King & Spalding on

On February 23, 2024, CMS published a final rule updating the regulatory requirements of the Medicaid disproportionate share hospital (DSH) program in response to the Consolidated Appropriations Act (CAA) of 2021. The final...more

Foley & Lardner LLP

CMS Expands Access to Behavioral Health Services; Physician Fee Schedule Expands Billing Providers and Flexibilities

Foley & Lardner LLP on

On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued its 2024 Physician Fee Schedule final rule (Final Rule) for calendar year 2024 that will, in part, implement some of the most important changes...more

Dechert LLP

Dechert Re:Torts - Key Developments in Product Liability and Mass Torts - Issue 10

Dechert LLP on

Senators Focus Attention on Litigation Funding’s Opacity - Building on the momentum we previously noted related to litigation funding, on September 14, Senator John Kennedy introduced the Protecting Our Courts from Foreign...more

Bricker Graydon LLP

Departments Roll Back Enforcement Discretion in New Guidance on Transparency in Coverage Rules.

Bricker Graydon LLP on

Well, it was good while it lasted. On September 27th, the Departments issued new FAQs regarding implementation of provisions of The Transparency in Coverage Final Rules (TiC Final Rules). ...more

King & Spalding

CMS Issues Final Rule for Skilled Nursing Facility Prospective Payment System for 2024

King & Spalding on

On July 31, 2023, CMS issued its final rule updating the rates and Medicare payment policies under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for FY 2024 (the Final Rule). The Final Rule also includes...more

Verrill

Gag Clauses – New Guidance and Litigation Will Inform Compliance

Verrill on

Certain provisions of the Transparency in Coverage Final Regulations and the Consolidated Appropriation Act, 2021 (“CAA”) require group health plans and/or their vendors to report information to federal agencies. On December...more

Bass, Berry & Sims PLC

CY 2023 Medicare Physician Fee Schedule: Medicare Telehealth Update

Bass, Berry & Sims PLC on

On November 2, 2022, the Centers for Medicare & Medicaid Services (CMS) issued the CY 2023 Medicare Physician Fee Schedule Final Rule (Final Rule), which will take effect January 1, 2023. The Final Rule includes noteworthy...more

Holland & Knight LLP

CMS Issues 2023 Medicare Physician Fee Schedule Final Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2023 Medicare Physician Fee Schedule (PFS) Final Rule on Nov. 1, 2022, which impacts Medicare Part B payments starting on Jan. 1, 2023....more

King & Spalding

CMS Issues Outpatient Prospective Payment System Final Rule for CY 2023

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On November 1, 2022, CMS published a final rule to update the payment policies, payment rates, and other provisions for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory...more

Foley & Lardner LLP

Expanded Medicare Telehealth Coverage for Opioid Use Disorder Treatment Services Furnished by Opioid Treatment Programs

Foley & Lardner LLP on

Starting January 1, 2023, Medicare will cover telehealth-based treatment services delivered by federally-accredited opioid treatment programs (OTPs), commonly referred to as “methadone clinics.” This new reimbursement is...more

Mintz - Employment Viewpoints

HHS, Treasury and Labor Issue More Guidance on the No Surprises Act

Title I of Division BB of the Consolidated Appropriations Act, 2021 (the “Act”), and interim final rules issued by the Departments of Health and Human Services, Treasury and Labor (the “Departments”) in July 2021 (see our...more

King & Spalding

CMS Issues Outpatient Prospective Payment System Proposed Rule for CY 2023

King & Spalding on

On July 15, 2022, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule to update the payment policies, payment rates, and other provisions for services furnished under the Medicare Outpatient...more

Williams Mullen

Health Plan Transparency Requirements are Effective Now

Williams Mullen on

The Consolidated Appropriations Act, 2021 (“CAA” or the “Act”) includes several transparency requirements for health plans. Some of these requirements are already in effect for plan years beginning on or after January 1,...more

McAfee & Taft

New health plan disclosure requirements should bring more transparency

McAfee & Taft on

Ten years ago, the U.S. Department of Labor (DOL) published a final regulation under the Employee Retirement Income Security Act of 1974 (ERISA) that required retirement plan service providers to disclose information about...more

McDermott Will & Emery

CMS Issues FY 2022 IPPS Final Rule, Implements Medicare GME-Related Provisions

McDermott Will & Emery on

In December 2021, the US Centers for Medicare and Medicaid Services (CMS) issued the second part of its FY 2022 Inpatient Prospective Payment System (IPPS) Final Rule with Comment Period. Among other policies, the Final Rule...more

King & Spalding

CMS Finalizes Statutory Changes to GME Rules

King & Spalding on

On December 17, 2021, CMS issued a final rule implementing three changes to Medicare’s payment rules for graduate medical education that Congress enacted last year in the Consolidated Appropriations Act, 2021 (CAA). The final...more

Holland & Knight LLP

CMS Finalizes Policies on Residency Positions and Organ Procurement Payment

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) has released the Final Rule with a comment period for the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals; Changes to Medicare Graduate Medical...more

Bradley Arant Boult Cummings LLP

After (Another) Unusual Year, We’re Very Thankful and Wish You a Happy Thanksgiving

Now that the pandemic’s “social distancing” is lessening, we hope you are all able to gather with friends and family this Thanksgiving. As we do the same, we wanted to count our blessings as we review the year. This year, we...more

Mintz - Health Care Viewpoints

Post-Pandemic Access to Telehealth:  Highlights of the CMS 2022 Physician Fee Schedule Final Rule

Last week, CMS announced its final Physician Fee Schedule Payment Policies (the “Final Rule”), which will become effective January 1, 2022. The Final Rule included several updates to Medicare coverage of telehealth services,...more

McGuireWoods Consulting

Physician Fee Schedule Final Rule Addresses Telehealth, Medicare Diabetes Prevention Program

McGuireWoods Consulting on

On Nov. 2, 2021, the Centers for Medicare and Medicaid Services (CMS) released a final rule to update the Physician Fee Schedule (PFS) and address other Medicare Part B issues for Calendar Year (CY) 2022. The rule, which goes...more

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