Jeffrey Davis on Healthcare

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

Biden Administration Issues Final Reg on Mental Health Parity Requirements

Biden Administration Issues Final Reg on Mental Health Parity Requirements McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. Click here to subscribe to future blog posts....more

9/12/2024 / Biden Administration , Centers for Medicare & Medicaid Services (CMS) , Children's Health Insurance Program (CHIP) , Department of Health and Human Services (HHS) , Employer Group Health Plans , Final Rules , Health Care Providers , Healthcare , Healthcare Reform , Medicare , Mental Health Parity Rule , MHPAEA , New Regulations , NQTLs , Regulatory Agenda , Regulatory Requirements

No Surprises Act Implementation Bumpy Period Reaches One-Year Mark

We are now in September! And while many folks are thinking about how summer has come and gone so quickly, those following the No Surprises Act implementation process may also be wondering how a whole year has passed since the...more

9/5/2024 / Billing , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Dispute Resolution , Health Care Providers , Healthcare , Healthcare Reform , No Surprises Act (NSA) , Surprise Medical Bills

Performance Year 2023 MIPS Payment Adjustments: A Return to Normal

While the phrase “return to normal” is used in many different contexts, interestingly, it can now also be applied to the maximum payment adjustments that clinicians receive through the Merit-based Incentive Payment System...more

8/29/2024 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Healthcare , Healthcare Reform , Legislative Agendas , Medicare , Medicare Payment Reform , MIPS , Quality Payment Program (QPP) , Regulatory Agenda

CMS Releases Final TCET Notice – Implications and Next Steps

Last week, the Centers for Medicare & Medicaid Services (CMS) issued a final procedural notice for the new Transitional Coverage for Emerging Technologies (TCET) pathway for certain US Food & Drug Administration (FDA)...more

8/15/2024 / Centers for Medicare & Medicaid Services (CMS) , Emerging Technologies , Food and Drug Administration (FDA) , Health Insurance , Healthcare , Legislative Agendas , Medical Devices , Medicare , New Legislation , Regulatory Agenda

CMS Releases FY 2025 Hospital Inpatient Prospective Payment System (IPPS) Final Update

On August 1, 2024, the Centers for Medicare & Medicaid Services (CMS) posted the Hospital Inpatient Prospective Payment System (IPPS) final update for fiscal year (FY) 2025, along with proposed policy and regulation changes....more

8/6/2024 / Centers for Medicare & Medicaid Services (CMS) , Final Rules , Health Care Providers , Healthcare , Hospitals , Inpatient Prospective Payment System (IPPS) , Medicare , Payment Systems

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

Regs, Regs and More Regs: The Biden Administration Releases Spring 2024 Unified Agenda

We are in the midst of a storm of regulations that are being released by the Centers for Medicare & Medicaid Services (CMS) and the US Department of Health and Human Services (HHS), including the Calendar Year (CY) 2025...more

7/11/2024 / Biden Administration , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Health Care Providers , Health Insurance , Healthcare , Healthcare Reform , Hospitals , Insurance Industry , Legislative Agendas , Medicare Advantage , Popular , Proposed Regulation , Regulatory Agenda

HHS Institutes Information Blocking Disincentives for Healthcare Providers

The long-awaited final reg is upon us! The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) released a final regulation earlier this week...more

6/27/2024 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Health Care Providers , Healthcare , Healthcare Reform , Information Blocking Rules , MIPS , OIG , ONC , Regulatory Requirements

“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

CMS Hosts Health Equity Conference: Key Insights and Perspectives

Last week, the Centers for Medicare & Medicaid Services (CMS) held the second annual CMS Health Equity Conference. The event drew several hundred in-person attendees, including my colleague Kayla Holgash, and thousands of...more

6/6/2024 / Centers for Medicare & Medicaid Services (CMS) , Children's Health Insurance Program (CHIP) , Digital Health , Equity , Health Care Providers , Healthcare , Healthcare Reform , Inpatient Prospective Payment System (IPPS) , Medicaid , Mental Health , Professional Conferences , Regulatory Agenda , Regulatory Reform , Reproductive Healthcare Issues , Substance Abuse

A Buffet of Hospital Alternative Payment Models: Will Too Many Entrees Be Overwhelming?

Over the last several months, the Center for Medicare and Medicaid Innovation (CMMI), within the Centers for Medicare & Medicaid Services (CMS), has introduced several alternative payment models (APMs) geared toward...more

5/30/2024 / Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , CMMI , Health Care Providers , Healthcare , Healthcare Reform

Telehealth: Regulatory Questions Amid Legislative Uncertainty

Where has the time gone? We have hit the one-year mark since the end of the COVID-19 public health emergency (PHE). Yes, you read that correctly. One year! One of the long-term consequences of the PHE was the shift in when...more

5/16/2024 / Centers for Medicare & Medicaid Services (CMS) , Consolidated Appropriations Act (CAA) , Healthcare , Medicare , Proposed Legislation , Regulatory Standards , Telehealth , Waivers

CMS Finalizes Major Reforms to Medicaid, Part 2: Medicaid Managed Care Reg

Medicaid Regs Part 2! Last week, Regs & Eggs took a deep dive into the Ensuring Access to Medicaid Services final reg, one of two regs that the Centers for Medicare & Medicaid Services (CMS) released to add new requirements...more

5/3/2024 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Children's Health Insurance Program (CHIP) , Fee-for-Service , Health Care Providers , Health Insurance , Health Insurance Exchanges , Healthcare , Managed Care Contracts , MCOs , Medicaid , Price Transparency , Proposed Regulation

Policy Update - CMS Releases Final Rule: Medicaid and CHIP Managed Care Access, Finance, and Quality

On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) published the Medicaid and Children’s Health Insurance Program Managed Care Access, Finance, and Quality final rule. CMS finalized several substantial...more

5/1/2024 / Centers for Medicare & Medicaid Services (CMS) , Children's Health Insurance Program (CHIP) , Final Rules , Healthcare , Healthcare Reform , Managed Care Contracts , Medicaid , Regulatory Agenda

2024 Chart of Additional Healthcare Regulations

During this election year, McDermottPlus is actively monitoring annual regulations that federal agencies are expected to release, as well as “ad hoc” regulations that will be released at the discretion of federal agencies. ...more

4/26/2024 / Centers for Medicare & Medicaid Services (CMS) , DEA , Department of Health and Human Services (HHS) , Department of Labor (DOL) , Department of Veterans Affairs , Employee Benefits , Federal Trade Commission (FTC) , Food and Drug Administration (FDA) , Health and Welfare Plans , Healthcare , Healthcare Reform , New Regulations , OCR , OIG , OSHA , Proposed Regulation , Regulatory Agenda , Regulatory Reform

CMS Finalizes Major Reforms to Medicaid, Part 1: Medicaid Access Reg

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released two final regulations that added new requirements for states when operating their Medicaid programs. Medicaid is currently the largest health...more

4/25/2024 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Healthcare , Healthcare Reform , Home and Community Based Services (HCBS) , Medicaid , Medicare

CMMI Proposes New Mandatory Episode-Based Payment Model

Last week, the Centers for Medicare & Medicaid Services (CMS) released the Fiscal Year 2025 Inpatient Prospective Payment System (IPPS) proposed regulation. This 1,900+ page annual reg updates Medicare payments and policies...more

4/18/2024 / Centers for Medicare & Medicaid Services (CMS) , CMMI , Comment Period , Health Care Providers , Healthcare , Healthcare Reform , Inpatient Prospective Payment System (IPPS) , Proposed Legislation , Proposed Regulation , Public Comment

Another News-Filled Medicare Advantage Regulatory Week

Although I previously declared January 2024 Medicare Advantage (MA) Month, this week has also been filled with news about the MA program. The Centers for Medicare & Medicaid Services (CMS) released the final rate announcement...more

4/4/2024 / Centers for Medicare & Medicaid Services (CMS) , Congressional Committees , Health Care Providers , Health Insurance , Healthcare , Legislative Agendas , Medicare , Medicare Advantage , Medicare Part C , Medicare Part D , MedPAC

COVID-Era Flexibilities Granted in Wake of Change Healthcare Cybersecurity Attack

Today marks one month since United Health Group’s (UHG) Change Healthcare reported that it had been hit by a cybersecurity attack. The attack has caused a major disruption to the US healthcare system, significantly impacting...more

3/21/2024 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Cybersecurity , Department of Health and Human Services (HHS) , Healthcare , MACs , Payment Systems , Popular , Public Health Emergency , Risk Management , Telehealth

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

The Doctor (Fix) Is In: Regulatory Implications of the Minibus Healthcare Package

Last Sunday, Congress released the text of a minibus package, which will likely be signed into law by tomorrow. While the bill’s primary purpose is to keep the government open, it also includes healthcare extenders through...more

3/7/2024 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Congressional Committees , Healthcare , Healthcare Reform , Legislative Agendas , Medicaid , Medicare Advantage , New Legislation , New Regulations , Payment Systems , Regulatory Agenda

The Maternal Health Crisis: What’s the Biden Administration Doing About It?

The U.S. is experiencing a maternal health crisis: it has one of the highest maternal mortality rates among high-income nations; increasing rates of complications from pregnancy or childbirth; and persistent disparities in...more

2/29/2024 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , GAO , Healthcare , Healthcare Reform , HRSA , Legislative Agendas , Proposed Legislation , Senate Committees , U.S. House

Jeffrey Davis

McDermott Will & Emery

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