News & Analysis as of

Consolidated Appropriations Act (CAA) Health Care Providers

McDermott+

Virtual Care Policy Update: What to Expect in Lame Duck

McDermott+ on

Updated November 18, 2024 – The Consolidated Appropriations Act (CAA), 2023 (Public Law 117-328), signed into law on December 29, 2022, extended certain key telehealth flexibilities instituted during the COVID-19 public...more

Ballard Spahr LLP

Surprise, Surprise! No Surprise Billing Regulations Upheld

Ballard Spahr LLP on

The Fifth Circuit Court of Appeals recently upheld regulations defining the qualifying payment amount (QPA). The QPA is a key factor in determining how much individuals and health plans must pay out-of-network providers in...more

Ballard Spahr LLP

Fifth Circuit Affirms Invalidity of No Surprises Regulations

Ballard Spahr LLP on

The Fifth Circuit Court of Appeals has affirmed the invalidity of regulations governing the independent review process under the No Surprise Billing Rules....more

Baker Donelson

Noteworthy GME Payment Policies and Opportunities for Residency Slots in CMS's FY 2025 IPPS Final Rule

Baker Donelson on

CMS's FY 2025 Inpatient Prospective Payment System (IPPS) Final Rule (Final Rule) finalizes several noteworthy proposals related to graduate medical education (GME) payment opportunities. Below are the takeaways from the...more

Manatt, Phelps & Phillips, LLP

New CMS Guidance on the Provision of Medicaid and CHIP Services to Incarcerated Children and Youth

This is an excerpt from a recent Manatt article published on State Health & Value Strategies. Click here to download insight. On July 23, 2024, the Centers for Medicare & Medicaid Services (CMS) released a State Health...more

Hall Benefits Law

DOL, HHS, and Treasury Release FAQs about No Surprises Act after TMA III

Hall Benefits Law on

The U.S. Departments of Labor (DOL), Health and Human Services (HHS), and Treasury, along with the Office of Personnel Management (OPM), released FAQs about the implementation of Title I of Division BB of the Consolidated...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

Mandelbaum Barrett PC

The No Surprises Act: A Look at What Dentists Need to Know

Mandelbaum Barrett PC on

The Federal No Surprises Act (“NSA”) was signed into law on December 27, 2020, as part of the Consolidated Appropriations Act of 2021. Since its enactment, the NSA has been supplemented on two occasions by regulations which...more

Weintraub Tobin

2024 Brings Expansion for Medicare-Payable Mental Health Providers

Weintraub Tobin on

In connection with the federal Consolidated Appropriations Act of 2023, marriage & family therapists (“MFTs”) as well as licensed professional clinical counselors (“LPCCs”) are eligible to receive payment from the Medicare...more

McDermott+

Regulatory Reflections from the Past Year

McDermott+ on

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

Rivkin Radler LLP

2024 Medicare Physician Fee Schedule Extends Telehealth Flexibilities

Rivkin Radler LLP on

The 2024 Medicare Physician Fee Schedule final rule, released by the Centers for Medicare & Medicaid Services (CMS) earlier this month, extended certain telehealth-related flexibilities that were implemented during the early...more

Baker Donelson

2024 Medicare Physician Fee Schedule Final Rule Extends COVID-19 Telehealth Policies and Includes Bonus Extension

Baker Donelson on

The CY 2024 Medicare Physician Fee Schedule Final Rule (Final Rule) implemented several statutory extensions to COVID-19 telehealth waivers and flexibilities, finalized proposed policies, and extended an important telehealth...more

Ballard Spahr LLP

No Surprises, But Much Uncertainty: The Status of CAA Billing Rules

Ballard Spahr LLP on

Summary - The rules in the Consolidated Appropriations Act that aim to eliminate much of the surprise from billings by out-of-network providers in particular situations are the subject of continued controversy....more

Stevens & Lee

New Stark Law Exception and Anti-Kickback Statute Safe Harbor Aim to Combat Physician Burnout

Stevens & Lee on

Health care professionals have faced increasing burnout and mental health issues in the wake of the COVID-19 pandemic. In an effort to address these rising issues, Congress passed the Dr. Lorna Breen Health Care Provider...more

Baker Donelson

CY 2024 Medicare Physician Fee Schedule: Extending Telehealth Flexibilities and Seeking Future Policy Input

Baker Donelson on

CMS recently released the CY 2024 Medicare Physician Fee Schedule (MPFS) Proposed Rule (Proposed Rule), which included many noteworthy proposals and clarifications related to Medicare telehealth services and other remote...more

Ballard Spahr LLP

Gag-Clause Attestations Due by End of Year

Ballard Spahr LLP on

Summary - By December 31, 2023, health plans and insurers must submit an attestation of compliance with the anti-gag rules of the Consolidated Appropriations Act, 2021 (CAA). The rules apply to all agreements entered into...more

K&L Gates LLP

Health Care Triage: The End of Continuous Medicaid Enrollment—What Health Systems Should Know

K&L Gates LLP on

In this episode, Alexander Chu and Ashley Davis review the end of the continuous Medicaid enrollment condition as a result of the Consolidated Appropriations Act, 2023. They discuss potential impacts of the disenrollment...more

ArentFox Schiff

Telehealth Flexibilities Continue After End of COVID-19 Emergency

ArentFox Schiff on

Telehealth experienced massive growth during the COVID-19 pandemic, due in no small part to various regulatory and reimbursement policies that federal agencies implemented following a declaration by the US Department of...more

McDermott Will & Emery

Congress Adds AKS and Stark Law Exceptions for Certain Wellness Programs

As a part of the Consolidated Appropriations Act, 2023 (CAA), Congress passed new exceptions to the Physician Self-Referral Law (Stark Law) and the federal Anti-Kickback Statute (AKS) allowing certain healthcare entities to...more

Morgan Lewis - Health Law Scan

Saved by the Bell? Telehealth Remains Largely Intact When PHE Ends

Healthcare providers are scrambling to understand the impacts of the May 11 expiration of the COVID-19 public health emergency (PHE). Luckily for most telehealth providers, the outlook of their operations post-PHE is...more

Holland & Knight LLP

COVID-19 PHE Ends May 11: What It Means for the Provision of Telehealth Under Medicare

Holland & Knight LLP on

The Biden Administration announced on Jan. 30, 2023, its intent to end the COVID-19 Public Health Emergency (PHE) on May 11, 2023. Fortunately, the 2023 Consolidated Appropriations Act (CAA) extends certain key telehealth...more

Ankura

FDA Authorized to Establish New Cybersecurity Standards for Medical Devices: What it Means for Industry

Ankura on

On December 29, 2022, President Biden signed a new statute that will significantly impact medical device cybersecurity regulation. Section 3305 of the Consolidated Appropriations Act of 2023 (“Section 3305”) authorizes the...more

Foley & Lardner LLP

What FQHCs Need to Know About Telehealth After the PHE

Foley & Lardner LLP on

On January 30, 2023, the Biden Administration announced its intent to end the COVID-19 public health emergency (PHE) on May 11, 2023. For Federally Qualified Health Centers (FQHCs), flexibilities offered under the PHE...more

Bass, Berry & Sims PLC

HHS-OIG Year in Review - 2022

Bass, Berry & Sims PLC on

The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) continues to offer valuable insights to the healthcare industry as to how best to approach increasingly complex healthcare fraud...more

Sheppard Mullin Richter & Hampton LLP

CMS Updates List of Telehealth Services for CY 2023

On February 13, 2023, the Centers for Medicare and Medicaid Services (CMS) published the revised List of Telehealth Services for Calendar Year (CY) 2023 (List). The List includes the services that are payable under the...more

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