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) ,
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Medicare ,
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Payment Systems ,
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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
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Health Care Providers ,
Health Insurance ,
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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
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
House Energy and Commerce Health Subcommittee Holds Legislative Hearing on 19 Bills. Lawmakers discussed 19 pieces of legislation designed to support patients and caregivers in the key areas of autism, heart defects,...more
2/19/2024
/ Ambulatory Surgery Centers ,
Caregivers ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Federal Trade Commission (FTC) ,
Legislative Agendas ,
MACs ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Part D ,
Mental Health ,
Outpatient Prospective Payment System (OPPS) ,
Proposed Legislation ,
Request For Information ,
Senate Committees ,
U.S. House
On January 31, 2024, the US Centers for Medicare & Medicaid Services (CMS) released the Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and D...more
Congress Returns Next Week to Face Imminent Funding Deadlines. The Senate will return to session on January 8, and the House will return on January 9. Lawmakers face an immediate time crunch on FY 2024 appropriations, as the...more
1/8/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
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Cybersecurity ,
Department of Health and Human Services (HHS) ,
Enrollment ,
GAO ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Medical Devices ,
Medicare ,
OMB ,
Physician Fee Schedule
House Passes Healthcare Legislation. The House brought two key bipartisan healthcare bills to the floor this week. The Lower Costs, More Transparency Act (H.R. 5378) was approved by a vote of 320–71, and the Support for...more
12/18/2023
/ Artificial Intelligence ,
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Department of Health and Human Services (HHS) ,
Drug Pricing ,
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Healthcare ,
Healthcare Reform ,
HELP ,
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Medicare ,
New Legislation ,
Pharmaceutical Industry ,
Prescription Drugs ,
Privacy Laws ,
Proposed Legislation ,
Senate Committees ,
Technology Sector ,
U.S. House
It’s Thanksgiving week, so instead of eating eggs with your regs, you should sit back, relax and reflect on the regs you are thankful for as you eat your turkey legs (or whatever you enjoy on Thanksgiving). Many of the...more
11/21/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Digital Health ,
Final Rules ,
Healthcare ,
Healthcare Reform ,
Inpatient Prospective Payment System (IPPS) ,
Medicare ,
Mental Health ,
New Legislation ,
New Regulations ,
No Surprises Act (NSA) ,
Outpatient Prospective Payment System (OPPS) ,
Physician Fee Schedule ,
Regulatory Agenda ,
Telehealth
Congress Passes Two-Tiered CR to Fund Government into Early 2024. In the absence of final passage of any of the 12 annual appropriations bills for FY 2024, Speaker Johnson (R-LA) unveiled a short-term CR, H.R. 6363, the...more
On October 30, 2023, the US Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) released a...more
CONGRESS -
Senate Finance Committee Holds Markup on Better Mental Health Care, Lower-Cost Drugs, and Extenders Act. The bipartisan package includes Medicare and Medicaid extenders, provisions to expand the mental health...more
11/10/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Legislative Agendas ,
Medicare ,
Mental Health ,
National Institute of Health (NIH) ,
Outpatient Prospective Payment System (OPPS) ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Physician Fee Schedule ,
Prescription Drugs ,
Regulatory Agenda ,
Senate Committees ,
Telehealth ,
U.S. House
On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2024 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more
On October 27, 2023, the Centers for Medicare & Medicaid Services (CMS) released the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Calendar Year (CY) 2024 final rule (CMS-1782-F). The rule finalizes minimal...more
CONGRESS -
House Republicans Working to Elect New Speaker. On October 11, House Majority Leader Scalise won the Republican Conference’s nomination to become Speaker of the House after last week’s motion to vacate Speaker...more
THIS WEEK’S DOSE -
Uncharted Territory in the House: The House voted to remove Rep. McCarthy (R-CA) as Speaker of the House, then recessed until at least October 11, when the House is slated to reconvene to elect a new...more
10/9/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
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Department of Labor (DOL) ,
Extensions ,
Food and Drug Administration (FDA) ,
Healthcare ,
Healthcare Reform ,
Laboratory Developed Tests ,
Legislative Agendas ,
Medicare ,
New Legislation ,
Over The Counter Drugs (OTC) ,
Pharmaceutical Industry ,
Preventive Health Care ,
Proposed Legislation ,
Proposed Rules ,
Regulatory Requirements ,
Request For Information ,
Telehealth ,
Telemedicine ,
Temporary Regulations ,
U.S. Treasury
CONGRESS -
Senators Sanders and Marshall Release Bipartisan Primary Care and Health Workforce Act. Released on September 14, the legislation would reauthorize funding for a number of healthcare workforce programs that are...more
9/20/2023
/ Centers for Disease Control and Prevention (CDC) ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Investigations & Hearings ,
Coronavirus/COVID-19 ,
DEA ,
Department of Health and Human Services (HHS) ,
Food and Drug Administration (FDA) ,
GAO ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicare ,
Pharmaceutical Industry ,
Proposed Legislation ,
U.S. House
Time’s up and pencils down! Comments on the calendar year (CY) 2024 physician fee schedule (PFS) proposed reg were due earlier this week. Now, the Centers for Medicare & Medicaid Services (CMS) will have to review them and...more
9/15/2023
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Medicare ,
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Physicians ,
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Quality Payment Program (QPP) ,
Telehealth
Congress is officially in recess for the month of August and will return after Labor Day. On the regulatory front, the Centers for Medicare & Medicaid Services (CMS) released the final fiscal year (FY) 2024 Inpatient...more
8/4/2023
/ Acute Facilities ,
Billing ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Final Rules ,
Health Care Providers ,
Healthcare ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Long Term Care Facilities ,
Medicare ,
Medicare Part D ,
No Surprises Act (NSA) ,
Patient Prospective Payment System ,
Payment Systems
On August 1, 2023, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2024 Inpatient Prospective Payment System (IPPS) final rule. The rule updates Medicare payment policies and quality reporting...more
The House and Senate were both in session this week, with healthcare activity at the committee level. The House Energy and Commerce Committee held a hearing on innovation and a markup of 15 healthcare bills. The Senate...more
7/24/2023
/ Billing ,
Centers for Disease Control and Prevention (CDC) ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Reform ,
HELP Act ,
Legislative Agendas ,
MCOs ,
Medicare ,
Proposed Legislation ,
SAMHSA ,
Senate Committees ,
Technology ,
Telehealth ,
U.S. House ,
Vaccinations
On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more
Congress was in session for a final week of legislative business before the two-week Independence Day recess. The House brought a small-business-focused healthcare bill to the floor, approving it along party lines....more
6/23/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
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Comment Period ,
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Health Information Technologies ,
Healthcare ,
Legislative Agendas ,
Legislative Committees ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
New Legislation ,
Proposed Legislation
The House and Senate were both in session this week, with healthcare activity continuing at the committee level. The House Energy and Commerce Committee held hearings on the Pandemic and All Hazards Preparedness Act (PAHPA)...more
6/16/2023
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Debt ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Healthcare ,
HELP ,
Hospitals ,
Legislative Agendas ,
Medicaid ,
Medicare ,
New Legislation ,
Pharmaceutical Industry ,
Proposed Legislation ,
Regulatory Agenda ,
Telehealth ,
Transgender
On April 26, 2023, the House Energy and Commerce Committee Health Subcommittee held a legislative hearing on 17 healthcare bills, including one that would direct the Centers for Medicare & Medicaid Services (CMS) to implement...more