Alissa Fleming on Centers for Medicare & Medicaid Services (CMS)

Proposed Rule for Nursing Homes: Key Updates for FY 2026

I. Introduction - The Centers for Medicare & Medicaid Services (CMS) issued the proposed rule on April 11, 2025, for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2026 update (the...more

5/15/2025 / Centers for Medicare & Medicaid Services (CMS) , Healthcare Facilities , Medicaid , Medicare , Nursing Homes , Patient-Driven Payment Model (PDPM) , Proposed Rules , Regulatory Reform , Skilled Nursing Facility

Trump's Executive Order Targets 340B Drug Pricing Program

President Trump issued an Executive Order on April 15, 2025, titled "Lowering Drug Prices by Once Again Putting Americans First," with the express goal of providing Americans and taxpayers access to prescription drugs. One...more

4/25/2025 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Drug Pricing , Executive Orders , Healthcare , Hospitals , Medicare , Prescription Drugs , Section 340B , Trump Administration

Federal Court Vacates LDT Final Rule

The U.S. District Court for the Eastern District of Texas vacated the Food and Drug Administration's (FDA) final rule on March 31, 2025, under which the FDA would have started regulating most laboratory-developed tests (LDTs)...more

4/15/2025 / Administrative Procedure Act , Appeals , Centers for Medicare & Medicaid Services (CMS) , Final Rules , Food and Drug Administration (FDA) , Judicial Authority , Laboratory Developed Tests , Life Sciences , Medical Devices , Regulatory Requirements , Vacated

Looking Back at 2024: Key Health Care Regulatory Legal Developments in Fraud and Abuse, Compliance, and Enforcement

The health care regulatory space realized significant regulatory and enforcement developments in 2024 that are influencing how providers and industry stakeholders approach various compliance measures and enforcement...more

CMS Enacts New CLIA Regulations Effective January 2025

On December 23, 2023, CMS issued its Final Rule, establishing new Clinical Laboratory Improvement Amendments (CLIA) regulations (the Final Rule). Several provisions only became effective December 28, 2024. CMS was driven to...more

3/14/2025 / Centers for Medicare & Medicaid Services (CMS) , Clinical Laboratories , Continuing Education , Final Rules , Health Care Providers , Healthcare , Life Sciences , Medicare , Regulatory Requirements

2025 Medicare Physician Fee Schedule: Payment and Overpayment Policies

On December 9, 2024, the Centers for Medicare & Medicaid Services' (CMS's) Calendar Year 2025 Physician Fee Schedule Final Rule (the Final Rule) was published in the Federal Register. The Final Rule includes noteworthy...more

12/13/2024 / Centers for Medicare & Medicaid Services (CMS) , False Claims Act (FCA) , Health Care Providers , Health Insurance , Healthcare , Medical Reimbursement , Medicare , Mental Health , Overpayment , Physician Fee Schedule , Physicians , Reimbursements , Telehealth , Telemedicine

Temporary Regulatory Relief for South Carolina Health Care Providers Responding to Hurricane Helene

South Carolina Governor Henry McMaster declared a State of Emergency on September 25, 2024, to prepare for Hurricane Helene. On September 29, 2024, the Federal Emergency Management Agency (FEMA) issued a Federal Major...more

10/7/2024 / Centers for Medicare & Medicaid Services (CMS) , Critical Access Hospitals , Department of Health and Human Services (HHS) , Disaster Aid , Health Care Providers , Health Insurance Portability and Accountability Act (HIPAA) , Healthcare Facilities , Home Health Agencies , Hurricane Season , Natural Disasters , Public Health Emergency , Severe Weather , Skilled Nursing Facility , Waivers

Significant Changes Affecting Hospitals in CMS's FY 2025 IPPS Final Rule

CMS published its FY 2025 Medicare Hospital Inpatient Prospective Payment System (IPPS) final rule on August 1, 2024. Under this final rule, CMS is implementing several changes to its Hospital Inpatient Quality Reporting...more

9/6/2024 / Centers for Medicare & Medicaid Services (CMS) , Final Rules , Health Care Providers , Healthcare , Healthcare Facilities , Hospitals , Inpatient Prospective Payment System (IPPS) , Medicare , Payment Systems , Safety Standards , Social Security Act

CMS Proposes Significant Changes to the Medicare Shared Savings Program and 60-Day Rule

Under the CY 2025 Medicare Physician Fee Schedule (PFS) proposed rule, CMS proposes several modifications to the Medicare Shared Savings Program (MSSP) that would become effective in performance year 2025. CMS also proposed...more

8/9/2024 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medical Reimbursement , Medicare , Overpayment , Physician Fee Schedule , Physicians

CMS Proposes Extending COVID-Era Telehealth and Supervision Flexibilities through CY 2025

The Centers for Medicare & Medicaid Services (CMS) proposed to extend a number of COVID-era regulatory flexibilities related to telehealth, remote services, and supervision in the CY 2025 Medicare Physician Fee Schedule (PFS)...more

7/30/2024 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , Healthcare , Medicare , Mental Health , Physician Fee Schedule , Physicians , Proposed Rules , Substance Abuse , Telehealth , Telemedicine

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

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

11/15/2023 / Centers for Medicare & Medicaid Services (CMS) , Consolidated Appropriations Act (CAA) , Health Care Providers , Hospitals , Medicare , Physician Fee Schedule , Physicians , Reimbursements , Telehealth

Significant 2024 Medicare Physician Fee Schedule Rule Proposals: E/M, Social Determinants of Health, and Behavioral Health

In this article, we highlight a number of policy proposals in the current year (CY) 2024 Medicare Physician Fee Schedule (MPFS) Proposed Rule that have significant health care delivery and operational implications. These...more

8/14/2023 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Physician Fee Schedule , Physicians , Proposed Rules , Risk Assessment , Telehealth

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

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

7/24/2023 / Centers for Medicare & Medicaid Services (CMS) , Consolidated Appropriations Act (CAA) , Health Care Providers , Medicare , Physician Fee Schedule , Physicians , Telehealth , Telemedicine

FY 2024 Hospice Payment Rate Updated Proposed Rule

On April 4, 2023, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule for FY 2024 addressing the Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice...more

5/8/2023 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Home Health Care , Hospice , Medicare

CMS Proposes Amendment to 60-Day Overpayment Rule that Would Remove "Reasonable Diligence" Standard and Replace with False Claims...

On December 27, 2022, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would, among other things, amend the existing regulations for Medicare Parts A, B, C, and D regarding the standard for an...more

2/13/2023 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Overpayment , Reimbursements

Alissa Fleming

Baker Donelson

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