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
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
Congress is back in session this week, with the House in today and the Senate returning tomorrow. They are back for a four-week stretch until the Memorial Day recess break. Congress has already moved many of the major bills...more
4/30/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Final Rules ,
Healthcare ,
Healthcare Reform ,
Home and Community Based Services (HCBS) ,
Legislative Agendas ,
Medicaid ,
New Legislation ,
Proposed Legislation ,
Senate Committees ,
U.S. House
On April 22, 2024 the Centers for Medicare & Medicaid Services (CMS) published the Medicaid Program; Ensuring Access to Medicaid Services final rule. The rule has a particular focus on home- and community-based services...more
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
While congressional debate and action will focus on aid to Israel this week, committees will continue to move forward their health agendas via hearings. The House Energy and Commerce Committee hearing on the Change Healthcare...more
4/16/2024
/ Congressional Review Act ,
Coronavirus/COVID-19 ,
Cyber Attacks ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Federal Budget ,
Healthcare ,
Healthcare Workers ,
Israel ,
Long-Term Care ,
Medicaid ,
Medicare
On January 9, 2024, the Centers for Medicare and Medicaid Services (CMS) approved the New York State (NY) 1115 Medicaid waiver “Medicaid Redesign Team” (MRT). The MRT is a long-standing waiver in NY that has continuously...more
PARTIAL SNOW DAY, PARTIAL SHUT DOWN?
Much of the federal government is closed today because of yesterday’s significant (for DC) and unexpected snowfall. However, part of the federal government is set to shut down this...more
Happy New Year! As we enter 2024, we want to lay out some of the main regulatory issues (both new and old) that McDermott+Consulting will be tracking over the next year. While these may evolve, we think they are still...more
1/4/2024
/ Artificial Intelligence ,
CARES Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Reform ,
Laboratory Developed Tests ,
Managed Care Contracts ,
Medicaid ,
Medicare ,
MIPS ,
No Surprises Act (NSA) ,
Physician Fee Schedule ,
Proposed Regulation ,
Regulatory Agenda ,
Regulatory Reform ,
Telehealth ,
Telemedicine
GOVERNMENT FUNDING EXPIRES SOON -
The government will run out of funding in 11 days, on November 17. The House will continue to work to advance annual appropriations bills this week. However, a continuing resolution (CR)...more
11/7/2023
/ Appropriations Bill ,
Centers for Medicare & Medicaid Services (CMS) ,
Federal Funding ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
Physician Fee Schedule ,
Section 340B ,
U.S. House
NEXT UP: SPEAKER MIKE JOHNSON -
The House officially has a speaker: Mike Johnson (R-LA).
On October 25, Rep. Johnson became Speaker Johnson with a final vote on the first ballot of 220–209.
Speaker Johnson, a...more
Do We End the Week with a Shutdown?
That is the question of the week. We’ll know the answer in five days, but right now, “yes” is a far more plausible answer than “no.”
On the House side, Speaker McCarthy will first...more
9/26/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Government Shutdown ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicare ,
Proposed Legislation ,
Senate Committees ,
U.S. House
Work Before July 4 Recess -
This is the last week before Congress heads out for a two-week July 4 recess, and appropriations work in Congress is ramping up.
The Senate Appropriations Committee will hold its first full...more
Debt Limit Extended . . . Now What?
Late last week, Congress reached a bipartisan, bicameral deal to suspend the debt ceiling into 2025. Over the weekend, President Biden signed the bill into law, preventing the United...more
6/6/2023
/ Biden Administration ,
Debt ,
Health Care Providers ,
Health Savings Accounts ,
Healthcare ,
HELP ,
Medicaid ,
New Legislation ,
Pharmacy Benefit Manager (PBM) ,
Proposed Legislation ,
Telehealth
The proposed rule would make transparency-related updates to state directed payments (SDPs). It would also require states to submit an annual payment analysis that compares managed care plans’ payment rates for routine...more
On May 3, 2023 the Centers for Medicare & Medicaid Services (CMS) published the proposed rule Medicaid Program; Ensuring Access to Medicaid Services. The proposed rule seeks to increase transparency in payment rates,...more
Lots of Healthcare Activity in Congress -
Activity in Congress focusing on healthcare issues has increased over the last few weeks and is not slowing down anytime soon. This week, the Senate Health, Education, Labor, and...more
5/1/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Drug Pricing ,
Health Care Providers ,
Healthcare ,
HELP ,
Medicaid ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Proposed Legislation ,
Proposed Rules ,
State Medicaid Programs ,
Transparency