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Medicare New Regulations

McDermott+

Highlights of the FY 2026 IPPS final rule

McDermott+ on

Recently, the Centers for Medicare & Medicaid Services (CMS) issued all the fiscal year (FY) 2026 Medicare final regulations for different facility types: hospice facilities, inpatient psychiatric facilities, inpatient...more

McDermott+

CMS releases CY 2026 Physician Fee Schedule Proposed Rule

McDermott+ on

On July 14, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B [CMS-13271]...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

Davis Wright Tremaine LLP

Navigating Aetna's Expanded Claim Edits: What Providers Need To Know and Do Before September 1, 2025

Aetna recently announced that effective September 1, 2025, its Claim and Code Review Program (CCRP) will expand to include additional claim coding edits for all commercial, Medicare, and Student Health claims. While the...more

Sheppard Mullin Richter & Hampton LLP

Congressional Budget Proposal Includes Adjustments to Dual-Eligible Enrollment Pathways and Medicare Savings Program Rules

In June 2025, the U.S. House of Representatives introduced a budget reconciliation bill titled the One Big Beautiful Bill Act (OBBBA). The legislation proposes a number of administrative changes to existing federal health...more

Hanson Bridgett

CMS Announces Care Compare Changes That Could Lead to Major Five-Star Impacts for Certain SNFs

Hanson Bridgett on

On June 18, Centers for Medicare and Medicaid Services published new guidance announcing a major change to the way Care Compare will display survey information and the methodology for calculating the health inspection score...more

DLA Piper

New Federal Initiatives Signal Digital Health Access as a Key Priority

DLA Piper on

Recent activity among lawmakers and federal agencies signal that the government may be poised to undertake meaningful legislative and administrative efforts to harness the potential of digital health innovation and to expand...more

Alston & Bird

Health Care Week in Review | White House Issues Executive Orders on Biosecurity and Domestic Drug Production; House Committee...

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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

Groom Law Group, Chartered

CMS Finalizes Updates to the Prescription Creditable Coverage Methodology Determination

In April 2025, the Centers for Medicare and Medicaid Services (“CMS”) issued multiple pieces of guidance related to Medicare Part D prescription drug coverage, including the Final CY 2026 Part D Redesign Program Instructions....more

DLA Piper

President Trump Signs Executive Order to Lower Prescription Drug Costs

DLA Piper on

President Donald Trump recently signed an Executive Order (EO) aimed at lowering the cost of prescription drugs, titled, “Lowering Drug Prices by Once Again Putting Americans First.” On April 15, 2025, through this EO, the...more

Frantz Ward LLP

Changes to Medicare Reporting Requirements for Workers’ Compensation Settlements

Frantz Ward LLP on

Federal law requires employers to consider Medicare’s potential interests when settling a workers’ compensation claim with a Medicare beneficiary. The foregoing generally involves the use of a Workers’ Compensation Medical...more

McCarter & English, LLP

Federal Telehealth Update

Congress has extended telehealth flexibilities through its recent federal spending bill, H.R. 1968, titled “Full-Year Continuing Appropriations and Extensions Act, 2025” (the Act). Notably for health care providers, among...more

Alston & Bird

Health Care Week in Review | HHS Announces Significant Workforce Reductions and Reorganization; FDA and NIH Nominees are Confirmed

Alston & Bird on

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+

Healthcare Preview for the Week of: March 3, 2025

McDermott+ on

Attention Turns to Government Funding - Last week, after some drama on the floor, the House passed its version of a budget resolution in a 217 – 215 vote, a week after the Senate passed its “skinny” resolution. For the...more

ArentFox Schiff

Investigations Newsletter: Second Circuit Partially Affirms Novartis’ Motion to Dismiss AKS Claims

ArentFox Schiff on

Second Circuit Partially Affirms Novartis’ Motion to Dismiss AKS Claims - Last week, the Second Circuit Court of Appeals affirmed the district court’s ruling that dismissed allegations from a whistleblower who claimed that...more

McDermott+

Another Trip to the Buffet: Highlights from the CY 2025 OPPS Final Reg

McDermott+ on

As mentioned last week, the Centers for Medicare & Medicaid Services (CMS) recently put out a large buffet of regs – too many to digest in one blog post. While we focused on the Calendar Year (CY) 2025 Physician Fee Schedule...more

McDermott+

Digesting the Huge Buffet of CMS Regs: Highlights from the CY 2025 PFS Final Reg

McDermott+ on

While we all are focused on the election results, let’s take a quick break to digest some regs and eggs. The Centers for Medicare & Medicaid Services (CMS) “spoiled” all of us in the health policy world with a huge buffet of...more

McDermott+

Medicare FFS Regs: Thrills and Chills Under the Trump and Biden Administrations

McDermott+ on

Happy Halloween! In the health policy world, there are two things on everyone’s mind this spooky season: the upcoming election and the major calendar year (CY) 2025 Medicare fee-for-service (FFS) final regs that should be...more

McDermott+

Biden Administration Issues Final Reg on Mental Health Parity Requirements

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Biden Administration Issues Final Reg on Mental Health Parity Requirements McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. Click here to subscribe to future blog posts....more

McDermott+

CMS Proposes New CoP for Obstetrical Services: With Great Power Comes Great Responsibility

McDermott+ on

In case you need a reminder given everything going on in Washington, DC, the Calendar Year (CY) 2025 Physician Fee Schedule (PFS) and CY 2025 Outpatient Prospective Payment System (OPPS) proposed regs were released a couple...more

McDermott+

“Reg Season” is Coming! Preview of the Physician Fee Schedule

McDermott+ on

School is out and it is summertime, which means only one thing in the health policy community: reg season! This is the time of the year when the Centers for Medicare & Medicaid Services (CMS) releases regulations that propose...more

McDermott+

McDermottPlus Check-Up: May 3, 2024

McDermott+ on

House Energy & Commerce Health Subcommittee Holds Legislative Hearing on Improving Medicaid Access. Daniel Tsai, deputy administrator and director of the Center for Medicaid and CHIP Services (CMCS), testified. Members...more

Arnall Golden Gregory LLP

CMS Publishes Final Rule on Medicare Advantage Agent Broker Compensation

On April 4, 2024, the Centers for Medicare & Medicaid Services (“CMS”) published its Final Rule amending the existing Medicare Advantage (“MA”) agent broker compensation regulations. The Final Rule has significant...more

McDermott+

REGS & TURKEY LEGS: The Regs We’re Thankful For

McDermott+ on

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

Bass, Berry & Sims PLC

Behavioral Health: Momentum Continues in the CY 2024 Medicare Physician Fee Schedule

Bass, Berry & Sims PLC on

On November 16, the Centers for Medicare & Medicaid Services (CMS) published its Medicare Physician Fee Schedule (PFS) final rule for calendar year 2024 (PFS Final Rule). According to the CMS press release, the PFS Final Rule...more

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