This past week, President Biden issued a Statement of Administration Policy announcing an intention to end both the Public Health Emergency (PHE) and the National Emergency declarations on May 11, 2023. While the...more
On Wednesday, June 15, 2022, in a unanimous decision, the U.S. Supreme Court decided in favor of the American Hospital Association in the case of American Hospital Association vs. Becerra, that the nearly 30 percent cuts in...more
6/22/2022
/ American Hospital Association ,
American Hospital Association et al v Becerra Secretary Of Health And Human Services et al ,
Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Health Care Providers ,
Hospitals ,
Medicare ,
Medicare Part B ,
Prescription Drugs ,
SCOTUS ,
Section 340B
After two years, a multitude of factors are pointing toward the end of the formal public health emergency declaration, related emergency declarations, and associated waivers in connection with COVID-19, including declining...more
On Monday, March 9, 2020, the Centers for Medicare and Medicaid (CMS) released information on permissible flexibilities and obligations that are in effect during a disaster and emergency resulting from COVID-19....more
3/13/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Emergency Response ,
Infectious Diseases ,
Medicare Advantage ,
Medicare Billing Privileges ,
Medicare Part D ,
Natural Disasters ,
New Guidance ,
Pharmacies ,
Prescription Drug Coverage ,
Provider Payments ,
State of Emergency ,
Waivers
Health care issues will remain a central focus in Washington throughout 2019. Having gained control of the House following the 2018 mid-term elections, Democrats now have the ability to block President Trump's legislative...more
2/12/2019
/ Affordable Care Act ,
Block Grants ,
Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
Congressional Oversight ,
Constitutional Challenges ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid Expansion ,
Medicare ,
Medicare for All ,
Political Parties ,
Popular ,
Prescription Drugs ,
Repeal ,
Stark Law ,
State Medicaid Programs ,
Trump Administration ,
Waivers
On August 1, 2018, the Departments of Treasury, Labor, and Health and Human Services (HHS) issued a final rule to expand the availability of short-term, limited duration insurance (STLDI or short-term plans). ...more
On Tuesday, July 24, the Centers for Medicare and Medicaid Services (CMS) issued a final rule intended to clarify the program methodology and reinstate payments under the Affordable Care Act's (ACA) permanent risk adjustment...more
On Friday, May 11, President Donald Trump and Department of Health and Human Services (HHS) Secretary Alex Azar presented the Administration's long-awaited plan to address drug pricing. The proposed framework, entitled,...more
On April 9, the Department of Health and Human Services (HHS) released the long-anticipated final Notice of Benefits and Payment Parameters (NBPP) for plan year 2019, providing standards for health insurers and the health...more
The wide-reaching Bipartisan Budget Act of 2018 (BBA), passed by Congress and signed by the President on February 9, 2018, extends and modifies dozens of health care programs, including extending funding for two years for...more
2/22/2018
/ ACOs ,
Affordable Care Act ,
Bipartisan Budget Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Medicare Part B ,
Medicare Part D
On February 20, 2018, the Departments of Treasury, Labor, and Health and Human Services (HHS) issued a proposed rule to expand the availability of Short-Term, Limited Duration Insurance (STLDI). Building on President Trump's...more
On February 6, 2018, the House voted 242-182 to pass a Continuing Resolution (CR) to extend government funding until March 23, 2018 (H.R. Res 128). The CR includes provisions to extend funding for a number of Medicare...more
In 2018, Congress may revisit proposals to enact either per capita caps or a block grant for Medicaid and offer broader flexibility on Medicaid expansion rules. However, major structural reform to Medicaid remains unlikely...more
Health care stakeholders are increasing pressure on Congress to continue funding for a series of Medicare "extenders" – Medicare program and payment policies that expired at the end of 2017. Some examples of the extenders...more
In a major development last fall, the Centers for Medicare and Medicaid Services (CMS) finalized its proposal to pay hospitals less for certain physician-administered drugs purchased through the 340B Drug Discount Program....more
On November 1 and 2, the Centers for Medicare and Medicaid Services (CMS) released the final 2018 Medicare Payment Regulations for the Physician Fee Schedule, Hospital Outpatient Prospective Payment System and Ambulatory...more
On November 2, the Centers for Medicare and Medicaid Services (CMS) released the final rule implementing policies for Year 2 (2018) of the Quality Payment Program established under the Medicare Access and CHIP Reauthorization...more
Reauthorization of federal funding for the Children's Health Insurance Program (CHIP) has stalled in Congress due to partisan disagreements over fiscal offsets. The delay in the extension of federal funding has put...more
After dominating the agenda for most of 2017, the Affordable Care Act (ACA) seemed to take a backseat at first as Republicans shifted their focus to enacting tax legislation. The initial momentum behind the bipartisan...more
11/20/2017
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Budget Office ,
Cost-Sharing ,
Health Insurance ,
Health Savings Accounts ,
Healthcare Reform ,
Individual Mandate ,
Open Enrollment ,
Repeal ,
Trump Administration
On June 20, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule entitled, "Medicare Program; CY 2018 Updates to the Quality Payment Program." CMS proposed changes for the second year (2018) of the...more
The Centers for Medicare & Medicaid Services (CMS) released several annual Medicare proposed payment rules over the summer that are expected to be finalized this fall for 2018.
On July 13, CMS released the proposed 2018...more
On July 13, the Centers for Medicare and Medicaid Services (CMS) released the proposed 2018 Physician Fee Schedule that would update payment policies, payment rates and quality provisions for physicians and other medical...more
On June 20, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule entitled, "Medicare Program; CY 2018 Updates to the Quality Payment Program." CMS proposes changes for the second year (2018) of the...more
6/26/2017
/ Alternative Payment Models (APM) ,
CEHRT ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Health Care Providers ,
Hospitals ,
Medicare Access and CHIP Reauthorization (MACRA) ,
MIPS ,
Physicians ,
Proposed Rules ,
Provider Payments ,
Public Comment
On May 24, the Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) released much-anticipated analysis of the House-passed American Health Care Act (AHCA). Overall, CBO projected that the AHCA would reduce...more
On June 10, the Center for Medicare and Medicaid Services (CMS) committed $10 million over the next three years to fund a second round of the Support and Alignment Networks under the Transforming Clinical Practice Initiative...more