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Patient Access Medicaid Centers for Medicare & Medicaid Services (CMS)

Jones Day

Medicare's Innovation Center Charts New Direction: Part 3 – Drugs, Devices, and Data

Jones Day on

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

Sheppard Mullin Richter & Hampton LLP

Continuity in Coverage: CMS Extends the Unwinding SEP & Issues Final Rule for Medicaid and CHIP Enrollment

On March 28, 2024, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced that it is extending the temporary special enrollment period (the Unwinding SEP)...more

Stotler Hayes Group, LLC

The Great Unwinding And Its Effect On Skilled Nursing Facilities

Following the termination of the Public Health Emergency (“PHE”) as a result of COVID-19, and the continuous enrollment provisions put in place to ensure that Medicaid beneficiaries were able to receive Medicaid benefits...more

Whiteford

New CMS Guidance on Use of Algorithms and AI in Prior Authorizations and Utilization Management

Whiteford on

Use of algorithms and artificial intelligence (AI) in prior authorization and utilization management is facing growing criticism and litigation. Notable lawsuits include alleged automatic authorization denials for tests that...more

King & Spalding

CMS Issues Final Rule Aimed at Improving Prior Authorization Processes

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On January 18, 2024, CMS released a pre-publication version of a final rule (the Final Rule) that will require Medicare Advantage organizations (MA or Part C), Medicaid and the Children’s Health Insurance Program (CHIP)...more

Nossaman LLP

CMS Attempts to Reduce Appointment Times for Medicaid and CHIP Patients - How Will This Impact Your Managed Care Plan?

Nossaman LLP on

A recent survey found that the average wait time for a new patient to see a physician in 15 of the largest cities in the U.S. was 26 days, up from 24.1 days in 2017.  Timely access to health care providers has long been an...more

McDermott+

CMS Releases Proposed Rule: Medicaid Program; Ensuring Access to Medicaid Services

McDermott+ on

On May 3, 2023 the Centers for Medicare & Medicaid Services (CMS) published the proposed rule Medicaid Program; Ensuring Access to Medicaid Services. The proposed rule seeks to increase transparency in payment rates,...more

Bricker Graydon LLP

Has COVID-19 forced the telehealth genie out of the bottle?

Bricker Graydon LLP on

The public health emergency caused by the COVID-19 pandemic has caused many changes to health care laws and regulations. It is anticipated that once the public health emergency ends, many of these laws and regulations will...more

Robinson+Cole Health Law Diagnosis

CMS Announces New Telehealth Services Covered by Medicare and Provides States with Medicaid and CHIP Telehealth Expansion...

On October 14, 2020, the Centers for Medicare & Medicaid Services (CMS) expanded the list of telehealth services covered by Medicare during the COVID-19 Public Health Emergency. CMS also announced it would be providing...more

Health Care Compliance Association (HCCA)

HHS finalizes rules to provide patients more control of their health data

Compliance Today (May 2020) - The U.S. Department of Health and Human Services (HHS) announced in a March 9, 2020, news release that it had “finalized two transformative rules that will give patients unprecedented safe,...more

McDermott Will & Schulte

CMS Releases Proposed Rule to Advance Interoperability and the Exchange of Medical Record and Plan Information

CMS issued a long-awaited proposed rule aimed at enhancing interoperability and increasing patient access to health information. If finalized, CMS’s proposed rule may require hospitals and payors to make significant...more

Sheppard Mullin Richter & Hampton LLP

Federal Regulatory Developments Brewing in Telehealth

Two federal agencies – the Centers for Medicare and Medicaid Services (“CMS”) and the Federal Communications Commission (“FCC”) – announced separate initiatives last week that stand to increase patient access to telehealth...more

Pierce Atwood LLP

CMMI Focuses on Behavioral Health

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CMS recently announced that the Center for Medicare and Medicaid Innovation (CMMI) is interested in lowering the cost of care for Medicare and Medicaid beneficiaries with behavioral health conditions while improving the...more

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