House Oversight and Accountability Committee Holds Hearing on PBMs. Republicans and Democrats shared concerns about the role and practices of PBMs. While generally supportive of free market principles, Republicans criticized...more
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
On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more
On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more
Senate HELP Committee Holds Hearing on Medical Debt. The hearing examined the negative impacts of medical debt and explored potential solutions to address the growing issue. Senators and witnesses highlighted the disparity...more
7/15/2024
/ Artificial Intelligence ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Data Privacy ,
Healthcare ,
Healthcare Reform ,
HELP ,
Legislative Agendas ,
New Legislation ,
ONC ,
Outpatient Prospective Payment System (OPPS) ,
Pharmaceutical Industry ,
Physician Fee Schedule ,
Proposed Legislation ,
Senate Committees ,
U.S. House
House Ways & Means Health Subcommittee Holds Hearing on Value-Based Care. The hearing examined the challenges and opportunities associated with delivering better health outcomes and Medicare savings through value-based care....more
7/1/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Department of Health and Human Services (HHS) ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
New Legislation ,
Proposed Legislation ,
Senate Committees ,
Telehealth ,
U.S. House
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
Senate Finance Committee Holds Hearing on Disability Benefits. The hearing discussed ways to improve work incentives for those on Social Security disability programs. Senators and witnesses noted that there are currently...more
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
House Energy & Commerce Committee Advances 13 Health Bills. The bipartisan legislation dealt with public health, Medicaid fraud and some small telehealth bills, but not the Medicare extension legislation that the committee is...more
House Oversight Subcommittee Hearing with Fauci. The hearing aimed to gather more information on the response to the COVID-19 pandemic by Anthony Fauci, MD, former National Institute of Allergy and Infectious Diseases...more
6/7/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Healthcare ,
Healthcare Reform ,
HELP ,
Legislative Agendas ,
Medicaid ,
Medicare ,
New Legislation ,
Pharmaceutical Industry ,
Proposed Legislation ,
Section 340B ,
Senate Committees ,
U.S. House
House Energy & Commerce Health Subcommittee Advances 21 Bills. The markup included legislation around telehealth, Medicaid, workforce and rare diseases. Of note, the subcommittee advanced a bill that included an extension of...more
5/20/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Laboratory Developed Tests ,
Legislative Agendas ,
Medicare Payment Reform ,
Proposed Legislation ,
Regulatory Agenda ,
Senate Committees ,
U.S. House
House Ways & Means Committee Marks Up Telehealth and More. The bills considered in the markup support expanding access to telehealth as well as access to healthcare in rural areas. All six bills passed out of the committee,...more
5/13/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicare ,
Medicare Advantage ,
Pharmaceutical Industry ,
Proposed Legislation ,
Senate Committees ,
U.S. House
House Energy & Commerce Health Subcommittee Holds Legislative Hearing on Improving Medicaid Access. Daniel Tsai, deputy administrator and director of the Center for Medicaid and CHIP Services (CMCS), testified. Members...more
5/6/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
DACA ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Final Rules ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicare ,
New Legislation ,
New Regulations ,
Regulatory Agenda ,
Senate Committees ,
U.S. House
A Quiet Healthcare Week on Capitol Hill. Congress was largely in recess this week, although the Senate returned briefly to complete consideration of a long-awaited foreign aid bill. Both chambers will return to session the...more
4/26/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Reform ,
HRSA ,
Legislative Agendas ,
Medicaid ,
Medicare ,
Non-Compete Agreements ,
Nursing Homes ,
Pharmaceutical Industry ,
Prescription Drugs ,
Proposed Legislation ,
Section 340B ,
Senate Committees ,
Skilled Nursing Facility ,
U.S. House
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
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
House Energy & Commerce Health Subcommittee Holds Hearing on Cybersecurity. During the hearing, there was bipartisan concern about UnitedHealth Group’s response to the Change Healthcare cyberattack and consensus around the...more
4/18/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
GAO ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Payment Systems ,
Pharmacy Benefit Manager (PBM) ,
Proposed Legislation ,
Senate Committees ,
U.S. House
Senate Finance Health Subcommittee Holds Roundtable on Substance Use Disorder Care. Panelists and members discussed how to improve treatment in federal health programs.
House Energy & Commerce Health Subcommittee Holds...more
4/15/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Chronic Care Managment (CCM) ,
Federal Health Care Programs (FHCP) ,
Food and Drug Administration (FDA) ,
Inpatient Prospective Payment System (IPPS) ,
Long-Term Care ,
Medicare ,
Proposed Rules ,
Prospective Payment System (PPS) ,
Substance Abuse ,
Telehealth
Senate HELP Committee Holds Field Hearing on Private Equity. In the hearing, held at the Massachusetts State House, members discussed the impact of private equity ownership on patients, providers, quality of care and...more
4/8/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Final Rules ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicare ,
New Legislation ,
Payment Systems ,
Proposed Legislation ,
U.S. House
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
On April 1, 2024, the US Centers for Medicare & Medicaid Services (CMS) released the Announcement of Calendar Year (CY) 2025 Medicare Advantage (MA) Capitation Rates and Part C and D Payment Policies (Rate Announcement). CMS...more
THIS WEEK’S DOSE President Releases FY 2025 Budget: The budget requests $130.7 billion in discretionary spending for the US Department of Health and Human Services (HHS) for fiscal year (FY) 2025. House Ways & Means Committee...more
Appropriations Update. On March 3, Congress released bill text for the CAA, 2024, which includes funding for six of the 12 appropriations bills: Agriculture-FDA, Military Construction-VA, Energy-Water, Transportation-HUD,...more
3/11/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Drug Pricing ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
HELP Act ,
Legislative Agendas ,
Medicare ,
Medicare Advantage ,
Pharmaceutical Industry ,
Prescription Drugs ,
Private Equity ,
Proposed Legislation ,
Senate Committees ,
U.S. House
Appropriations Update. As appropriators continue to finalize the 12 funding bills for fiscal year (FY) 2024 – which began on October 1, 2023 – a series of stopgap CRs have been needed to avoid a government shutdown. This...more
3/4/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Payment Systems ,
Pharmaceutical Industry ,
Prescription Drugs ,
SAMHSA ,
Senate Banking Committee ,
Senate Committees