Hospitals and health systems are facing significant financial and operational challenges, including inadequate reimbursements, rising labor costs, and regulatory and economic uncertainties. These hurdles, coupled with the One...more
Consistent with recent attention from Congress and rhetoric from the Trump administration, the Calendar Year 2026 Medicare Hospital Outpatient Prospective Payment System (OPPS) proposed rule (the Proposed Rule) includes...more
7/28/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
Physicians ,
Prescription Drugs ,
Proposed Rules ,
Regulatory Reform ,
Trump Administration
Medicare reimbursement for hospital outpatient services has come under attack in recent years, with a focus on “site neutral” payment policies that would pay hospitals for outpatient services furnished in off-campus locations...more
The Centers for Medicare and Medicaid Services (CMS) recently announced the release of updated model signage for use by Medicare-participating hospitals to inform patients of their rights under the Emergency Medical Treatment...more
At the onset of the COVID-19 PHE, CMS was permitted to issue several temporary emergency statutory and regulatory waivers to help providers appropriately respond to the pandemic. On May 1, 2023, the Secretary released a memo...more
5/11/2023
/ Acute Facilities ,
Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Health Care Providers ,
Home Health Care ,
Hospice ,
Hospitals ,
Long Term Care Facilities ,
Mental Health ,
Public Health Emergency ,
Skilled Nursing Facility ,
Waivers
Effective January 1, 2023, The Joint Commission (TJC) eliminated 168 (or 14%) of its accreditation standards across all of its accreditation programs and revised 14 other standards. To further streamline its standards, TJC is...more
2/15/2023
/ Accreditation ,
Ambulance Providers ,
Centers for Medicare & Medicaid Services (CMS) ,
Certifications ,
Coronavirus/COVID-19 ,
Critical Access Hospitals ,
Health Care Providers ,
Home Health Care ,
Hospitals ,
Laboratories ,
Mental Health ,
Regulatory Agenda ,
Regulatory Standards ,
Skilled Nursing Facility ,
The Joint Commission
In late January 2023, the Centers for Medicare and Medicaid Services (CMS) issued two updates relevant to provider and supplier organizations enrolled in Medicare: (1) a redesign to the Provider Enrollment, Chain and...more
Starting July 1, 2023, The Joint Commission (TJC) will set health equity as a National Patient Safety Goal for certain TJC-accredited organizations and roll out a new Health Care Equity certification program to recognize and...more
2/1/2023
/ Affordable Care Act ,
Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Certifications ,
Critical Access Hospitals ,
Health Care Providers ,
Hospitals ,
Mental Health ,
Patients ,
Proposed Rules ,
The Joint Commission
Rural emergency hospitals (REHs) are a new provider type that will allow Medicare to pay for emergency department and other outpatient hospital services in rural areas beginning on January 1, 2023, without requiring the...more
11/29/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Emergency Rooms ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Medicare ,
Outpatient Services ,
Provider Payments ,
Rural Areas ,
Rural Health Care Providers ,
Stark Law
CMS released guidance for surveyors that provides leeway in surveying for compliance with the November 2021 interim final rule with comment that imposed a vaccination mandate for most staff at certain covered provider types....more
Beginning in 2023, Medicare will recognize a new provider type: the Rural Emergency Hospital (REH). The establishment of REHs is intended to preserve access to emergency departments and other outpatient services in rural...more
8/11/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Critical Access Hospitals ,
Emergency Rooms ,
Health Care Providers ,
Hospitals ,
Medicare ,
Outpatient Services ,
Physician Ownership ,
Physicians ,
Proposed Rules ,
Provider Payments ,
Rural Areas ,
Rural Health Care Providers ,
Stark Law ,
Statutory Requirements ,
Webinars
Rural emergency hospitals (REHs) are a new Medicare provider type that will allow Medicare to pay for emergency department and other outpatient hospital services in rural areas beginning on January 1, 2023, without requiring...more
7/21/2022
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Conditions of Participation (CoP) ,
Dedicated Emergency Departments ,
Enrollment ,
Hospitals ,
Medicare ,
Mental Health ,
Outpatient Prospective Payment System (OPPS) ,
Outpatient Services ,
Proposed Rules ,
Rural Health Care Providers
Tucked into the recent proposed rule establishing Rural Emergency Hospital Conditions of Participation (CoPs) is a proposal to change the CoPs for critical access hospitals (CAHs). The Centers for Medicare & Medicaid Services...more
On June 30, 2022, the Centers for Medicare & Medicaid Services (CMS) released the long-awaited proposed rule establishing the Conditions of Participation (CoPs) that Rural Emergency Hospitals (REHs) would be required to meet...more
Employers are amending their vaccine policies in the wake of US Supreme Court opinions. Michelle Strowhiro, Sandra DiVarco and Abigail Kagan discuss the three vaccine rules at play - OSHA Emergency Temporary Standard (ETS),...more
Hospital and health systems rely on vendors and other partners to provide vital services that support patient care, efficient operations and smooth administrative functions. However, the regulations governing different types...more
On January 13, 2022, the Supreme Court of the United States released two emergency opinions that change the landscape of the three federal vaccine rules. In summary:
A 5-4 Court majority let the Centers for Medicare &...more
On December 28, 2021, the Centers for Medicare and Medicaid Services (CMS) Quality, Safety and Oversight Group released a memorandum (QSO-22-07-ALL) providing guidance and details on survey procedures for assessing and...more
12/30/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Deadlines ,
Disability ,
Employer Liability Issues ,
Employer Mandates ,
Essential Workers ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Workers ,
Interim Final Rules (IFR) ,
Religious Accommodation ,
State and Local Government ,
Vaccinations
A flurry of litigation in federal district and appellate courts has led to an even split between states in which the COVID-19 vaccine mandate issued by the Centers for Medicare and Medicaid Services may be implemented and...more
On November 12, 2021, the Centers for Medicare and Medicaid Services (CMS) released an updated version of its Quality, Safety and Oversight Group memorandum, QSO-19-13-Hospital, containing much-anticipated final guidance on...more
The Centers for Medicare and Medicaid Services (CMS) published an interim final rule with comment period (IFR) on November 5, 2021, that implements the Biden administration’s previously announced vaccine mandate for...more
On November 4, 2021, the US Occupational Safety and Health Administration (OSHA) unveiled its Emergency Temporary Standard (ETS) to protect employees of large employers in all industries from COVID-19. The Centers for...more
11/5/2021
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Deadlines ,
Employees ,
Employer Liability Issues ,
Employer Mandates ,
Executive Orders ,
Federal Contractors ,
Final Rules ,
Health Care Providers ,
Healthcare Workers ,
OSHA ,
Public Health Emergency ,
Vaccinations ,
Virus Testing ,
Workplace Safety
On September 9, 2021, US President Joe Biden announced a multipronged plan to increase the number of Americans who are vaccinated for COVID-19. In the plan, titled “Path Out of the Pandemic: President Biden’s COVID-19 Action...more
9/27/2021
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Employees ,
Employer Liability Issues ,
Employer Mandates ,
Executive Branch ,
Executive Orders ,
Federal Contractors ,
Healthcare Facilities ,
Healthcare Workers ,
OSHA ,
Vaccinations ,
Virus Testing
Under current Medicare program rules, Medicare does not recognize “freestanding emergency departments” or other non-hospital providers of emergency department services. Medicare will only pay for these services at facilities...more
The Centers for Medicare and Medicaid Services (CMS) notified state survey agency directors that it has lifted previously imposed hospital survey suspensions and resumed routine hospital reaccreditation and recertification...more