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Health Care Providers Medicare Healthcare Reform

McDermott+

Back for seconds: digital health policies in the CY 2026 PFS proposed rule

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It’s been more than two weeks since the release of the CY 2026 Medicare Physician Fee Schedule (PFS) proposed rule. We’ve had a chance to digest our initial helping and now we’re ready for seconds. We thought we would see...more

Sheppard Mullin Richter & Hampton LLP

Potential False Claims Act Liability for Providers of Gender-Affirming Care for Minors

On July 9, 2025, the U.S. Department of Justice (“DOJ”) announced it sent more than 20 subpoenas to physicians and clinics involved in providing gender-affirming care to minors, and that the subpoenas related to...more

Bass, Berry & Sims PLC

CMS Proposes Mandatory Two-Sided Risk Model for Specialists Treating Heart Failure and Low Back Pain

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On July 16, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule for the Ambulatory Specialty Model (ASM), a mandatory, five-year alternative payment model for select specialists who regularly treat...more

King & Spalding

CMS Escalates Aggressive Rates Cut in Home Health Prospective Payment System Proposed Rule for CY 2026

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On June 30, 2025, CMS issued its annual Home Health Prospective Payment System Proposed Rule for Calendar Year (CY) 2026 (the Proposed Rule). The Proposed Rule continues the agency’s policy of using provisions of the...more

Jones Day

CMS Updates Kidney Care Choices Model

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The Center for Medicare and Medicaid Innovation ("CMMI") announced sweeping changes to the Kidney Care Choices Model ("KCC Model"), a key set of value-based programs....more

McDermott+

Healthcare Extenders Tracker (July 2025 Update)

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Many healthcare programs are extended for specific time periods, as short as one or two years or as long as 10, and are usually attached to a larger piece of must-pass legislation. Additionally, while traditional...more

McDermott+

Three key takeaways from the CMS Innovation Center’s new WISeR Model

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The last week of June was a busy one when it comes to news about prior authorization – a major tool used by health plans and the federal government to manage healthcare utilization. The week started with a commitment from...more

Alston & Bird

Health Care Week in Review | Congress Passes One Big Beautiful Bill Act; CMS Releases Proposed Payment Rules for ESRD and Home...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Benesch

CMS Launches WISeR Model: A Technology-Enabled Effort to Reduce Wasteful Medicare Spending

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On June 27, 2025, the Centers for Medicare & Medicaid Services (“CMS”), through its Innovation Center (“CMMI”), released the Request for Applications (“RFA”) for a new payment and service delivery initiative: the Wasteful and...more

Alston & Bird

Health Care Week in Review | Senate Parliamentarian Issues Rulings on Budget Reconciliation Provisions; Supreme Court Upholds the...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Bradley Arant Boult Cummings LLP

Alabama CON Report - June 2025

I. Certificate of Need Program - A. AL2024-031, Springhill Hospital, Inc. d/b/a Springhill Medical Center, Mobile County, AL: Proposes to add twenty (20) inpatient rehabilitation beds to an existing eighteen (18) bed...more

Alston & Bird

Health Care Week in Review | Senate Finance Committee Releases Budget Reconciliation Text; SCOTUS Upholds TN Ban on...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Spilman Thomas & Battle, PLLC

The Health Record - Healthcare Law Insights, V 2, Issue 6, June 2025

Welcome to our sixth issue of 2025 of The Health Record -- our healthcare law insights e-newsletter. In this edition, we look at the impact of supply chain and tariff issues on the industry, the veto of Florida's...more

Jones Day

Medicare's Innovation Center Charts New Direction: Part 1 - Providers

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The Center for Medicare and Medicaid Innovation ("CMMI") is set to reshape value-based care. In the first of a three-part series highlighting this new direction, this summary is focused on CMMI's efforts regarding health care...more

Sheppard Mullin Richter & Hampton LLP

Takeaways from the America’s Physician Groups’ Spring Conference: Turbulent Times Call for Change and Innovation

“Kicking Off Accountable Care” served as the theme for this year’s America’s Physician Groups’ (“APG”) Spring Conference, a three-day event packed with compelling speakers and breakout sessions focused on the state of...more

Burr & Forman

Considerations Before Opting Out of Medicare

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In recent years, we have seen an emerging number of physicians and health care providers transitioning to concierge, direct-to-consumer practices. Many providers no longer want to deal with the hassles of billing insurance,...more

McDermott Will & Schulte

Healthcare Regulatory Check-Up Newsletter | April 2025 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for April 2025, including Centers for Medicare & Medicaid Services (CMS) updates to Medicare Advantage (MA) and other Medicare programs....more

McDermott+

Healthcare Preview for the Week of: May 19, 2025

McDermott+ on

MAHA and More Medicaid - Late Sunday night, May 18, 2025, the House Budget Committee voted to advance the reconciliation package drafted by the Energy and Commerce Committee and Ways and Means Committee last week. The four...more

J.S. Held

All Is Not What It Seems, Or When Is A Dollar A Dime?

J.S. Held on

Welcome to the strange and mysterious world of medical billing. If ever there was an industry in which the charges and the payments have no correlation, the medical industry is it. Medical billing can indeed be quite...more

Alston & Bird

Health Care Week in Review | President Trump Announces Actions to Lower Prescription Drug Costs; House Committees Mark Up Their...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Alston & Bird

Health Care Week in Review | President Trump Unveils FY 2026 Discretionary Budget Request; Budget Reconciliation Negotiations in...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

McDermott Will & Schulte

Healthcare Regulatory Check-Up Newsletter | March 2025 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights key regulatory and enforcement activity for March 2025. This month features: - Noteworthy enforcement actions demonstrating that the Anti-Kickback Statute...more

Alston & Bird

Health Care Week in Review | President Trump Announces Actions to Lower Drug Prices; Trump Administration Initiates Section 232...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

McDermott Will & Schulte

CMS Updates SNF Attachment Guidance Ahead of May 1 Enrollment Deadline

Skilled nursing facilities (SNFs) historically have been required to disclose ownership and managerial control information as part of their Medicare enrollment. However, these requirements were significantly expanded to...more

Alston & Bird

Health Care Week in Review | House and Senate Agree to Budget Resolution; CMS Releases Inpatient and Post-Acute Payment Proposed...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

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