The U.S. Department of Health and Human Services (HHS) issued four major rules on Nov. 20, 2020, which was the final day for the Trump Administration to issue a rule with a 60-day implementation period for it to take effect...more
12/8/2020
/ Amended Rules ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Health Care Providers ,
Medicare ,
Medicare Advantage ,
Pharmaceutical Industry ,
Public Comment ,
Rulemaking Process ,
Stark Law
The 21st Century Cures Act (Cures Act) included several provisions to accelerate the adoption and effective use of health information technology (HIT) and discourage information blocking. The Secretary of U.S. Department of...more
The Centers for Medicaid & Medicaid Services (CMS) has released the Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Final...more
The Centers for Medicare & Medicaid Services (CMS) published the Calendar Year (CY) 2021 Proposed Rule for the Medicare Physician Fee Schedule (MPFS), which contains updates to the Quality Payment Program (QPP). The MPFS...more
Before the pandemic, telehealth coverage was limited in scope. However, the Centers for Medicare & Medicaid Services (CMS) recently expanded coverage through its regulatory authority and waivers to encourage broad adoption of...more
Under Section 1557 of the Affordable Care Act (Section 1557), "covered entities," which were defined as health programs or activities that receive "federal funding" from the U.S. Department of Health and Human Services (HHS)...more
The Coronavirus Aid, Relief, and Economic Security (CARES) Act provided $200 million to the Federal Communications Commission (FCC) to support healthcare providers in the fight against the ongoing pandemic. On March 30, the...more
Below is a summary of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), a $2 trillion stimulus package that is the third phase of the federal government's response to the coronavirus (COVID-19) pandemic. The...more
Congress has provided an unprecedented infusion of funding and other financial relief through a variety of new and existing programs to address the coronavirus (COVID-19) outbreak. This blog post outlines how the federal...more
3/31/2020
/ CARES Act ,
Centers for Disease Control and Prevention (CDC) ,
Coronavirus/COVID-19 ,
Federal Funding ,
Financial Stimulus ,
Health Care Providers ,
Hospitals ,
Medicare ,
National Institute of Health (NIH) ,
Public Health ,
Public Health Emergency ,
Relief Measures
On the day following the enactment of the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act), the Centers for Medicare & Medicaid Services (CMS) made clear its intention to expand the groups of medical...more
Please note: This posting was updated with new developments on March 29, 2020. On March 6, Congress passed the Coronavirus Supplemental Appropriations Act (H.R. 6074), which included a $500 million authorization to enhance...more
On March 6, Congress passed the Coronavirus Supplemental Appropriations Act (H.R. 6074), which included a $500 million authorization to enhance telehealth services. The legislation gives the U.S. Department of Health and...more
3/25/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Emergency Response ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicaid ,
Medicare ,
OIG ,
Relief Measures ,
Telehealth ,
Telemedicine
The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) on March 9, 2020, released separate but related final rules addressing interoperability,...more
The Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director (SMD) letter and fact sheet on Jan. 30, 2020, that encouraged states to pursue block grant or per capita cap funding through their Medicaid...more
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, released the Calendar Year (CY) 2020 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule....more
11/13/2019
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Community Health Systems ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
Rural Health Care Providers ,
Section 340B ,
Transparency
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, published the Calendar Year (CY) 2020 Final Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B,...more
11/11/2019
/ Alternative Payment Models (APM) ,
Ambulance Providers ,
Bundled Payments ,
Centers for Medicare & Medicaid Services (CMS) ,
Drug Treatment ,
Final Rules ,
Health Care Providers ,
Medical Records ,
Medicare ,
Medicare Part B ,
MIPS ,
Open Payments ,
Opioid ,
PHI ,
Physician Fee Schedule ,
Physicians ,
Public Comment ,
Quality Payment Program (QPP) ,
Substance Abuse ,
Telehealth
The Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAHMSA) released its long-awaited proposal to overhaul privacy restrictions for substance abuse treatment programs found...more
8/26/2019
/ Comment Period ,
Confidential Information ,
Consent ,
Electronic Protected Health Information (ePHI) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medical Records ,
NPRM ,
Patient Privacy Rights ,
Proposed Amendments ,
Proposed Rules ,
Substance Abuse
On August 2, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital Prospective Payment System...more
8/9/2019
/ Applications ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Inpatient Quality Reporting ,
Long Term Care Facilities ,
Medicaid ,
Medicare ,
Payment Systems ,
Proposed Rules ,
Public Comment ,
Rulemaking Process ,
Value-Based Purchasing ,
Wage Index
On June 24, 2019, President Trump signed a long-awaited executive order that he said would "fundamentally" change the healthcare market. The order builds upon current regulations that require hospitals to make available a...more
6/26/2019
/ Data Reporting ,
Disclosure Requirements ,
Executive Orders ,
Health Care Providers ,
Health Insurance ,
Health Savings Accounts ,
Healthcare Costs ,
Hospitals ,
Out-of-Pocket Expenses ,
Outpatient Prospective Payment System (OPPS) ,
Price Transparency ,
Proposed Rules ,
Surprise Medical Bills ,
Trump Administration
• The Centers for Medicare & Medicaid Services (CMS) on April 23, 2019, released the Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule.
• The proposed payment rate increase...more
5/1/2019
/ Add-ons ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Fiscal Year ,
Food and Drug Administration (FDA) ,
Graduate Medical Education ,
Health Care Providers ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Inpatient Quality Reporting ,
Long Term Care Facilities ,
Proposed Rules ,
Public Comment ,
Rulemaking Process ,
Value-Based Purchasing ,
Wage Index
The Centers for Medicare & Medicaid Services (CMS) announced five new, voluntary value-based payment models for primary care: Primary Care First and Direct Contracting. Applications are expected to open shortly, and both...more
President Trump's budget was released yesterday as the fiscal year (FY) 2020 appropriations process ramps up. The FY 2020 budget requests $87.1 billion in discretionary funding for the Health and Human Services (HHS)...more
3/14/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Emergency Rooms ,
Federal Budget ,
FQHC ,
Health Care Providers ,
Medicaid ,
Medicare ,
Public Health ,
Trump Administration ,
Veterans Administration
CMS Regulation -
CMS and ONC Unveil Proposals Transforming Interoperability and Patient Access to Data -
The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health...more
3/1/2019
/ 21st Century Cures Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Electronic Health Record Incentives ,
Electronic Protected Health Information (ePHI) ,
Enforcement Actions ,
False Advertising ,
False Claims Act (FCA) ,
Federal Trade Commission (FTC) ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Health Information Technologies ,
Health Insurance Portability and Accountability Act (HIPAA) ,
ONC ,
Opioid ,
Proposed Rules
On Jan. 31, 2019, the Department of Health and Human Services' (HHS) Office of the Inspector General (OIG) issued a long-awaited proposed rule that would, if finalized, remove the existing legal "safe harbor" that protects...more
2/5/2019
/ Comment Period ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Exemptions ,
Health Care Providers ,
Health Plan Sponsors ,
Manufacturers ,
MCOs ,
Medicaid ,
Medicare ,
Medicare Part D ,
OIG ,
Pharmaceutical Industry ,
Pharmacies ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Proposed Rules ,
Public Comment ,
Rebates ,
Safe Harbors ,
Trump Administration
• The Centers for Medicare & Medicaid Services (CMS) has issued the Calendar Year (CY) 2019 Final Rule that updates payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory...more
11/13/2018
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Data Collection ,
Emergency Rooms ,
Final Rules ,
Health Care Providers ,
Health Clinics ,
Hospitals ,
Medicare ,
Off-Campus Departments ,
Outpatient Prospective Payment System (OPPS) ,
Payment Rates ,
Physician Fee Schedule ,
Physician Medicare Reimbursements ,
Physicians ,
Policies and Procedures ,
Prescription Drugs ,
Section 340B