On September 23, 2024, the Centers for Medicare & Medicaid Services (CMS) held an education session regarding the August 7, 2024 final procedural notice, which finalized the Transitional Coverage for Emerging Technologies (TCET) pathway (CMS-3421). On August 7, CMS also published final guidance documents on Coverage with Evidence Development, National Coverage Analysis Evidence Review, and […]
Read MoreCritical Access Hospitals (CAHs) are vital in delivering healthcare services to the approximately 60 million Americans living in rural areas. By providing essential inpatient, outpatient, and emergency services, CAHs often become the main point of care for underserved communities located far from larger medical centers. They also operate under different Medicare Conditions of Participation than […]
Read MoreIn an era in which weight loss drugs dominate news headlines and telehealth platforms put prescriptions just a click away, Americans are reimagining medicine's potential—and how they access it. This has driven new interest in compounding pharmacies, which promise bespoke solutions crafted to meet individual needs and sometimes claim to deliver the chemical equivalents of [...] Read More
As the 2024 election year unfolds, healthcare remains a priority for U.S. voters. Frustrated by gridlock at the national level, many are turning their attention to state governments, which are pursuing a variety of efforts to tackle pressing healthcare issues. Governors and state legislatures are exploring state-level solutions to healthcare issues and making policy choices [...] Read More
On August 1, 2024 the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2025 Hospital Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals and the Long-Term Care Hospital (LTCH) Prospective Payment System final rule. See the press release here. CMS released a fact sheet accompanying the rule. The rule finalizes […]
Read MoreOn July 31st, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2025 Prospective Payment System (PPS) and Consolidated Billing for Skilled Nursing Facilities (SNFs) final rule. CMS released a fact sheet accompanying the rule. The rule finalizes proposals to: Increase SNF PPS payment rates by 4.2 percent, Rebase and revise […]
Read MoreOn July 10, the Office of the National Coordinator for Health Information Technology (ONC)[1] released the Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule, which would implements provisions of the 21st Century Cures Act. This proposed rule was then released by the US Department of Health and […]
Read MoreIn July, the Senate unanimously passed legislation that would limit the number of patents drugmakers can assert for a single product. Touted as a step toward improving the affordability of medications, the legislation has highlighted the debate over the impact of "patent thickets" in drug manufacturing. The bipartisan Affordable Prescriptions for Patients Act of 2023 [...] Read More
On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Hospital Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center (ASC) Payment Systems proposed rule, which proposes updates to the Medicare OPPS and ASC payment system for calendar year (CY) 2025. See the press release here and the fact sheet here. This […]
Read MoreThe Supreme Court concluded its 2023-2024 term with several rulings with significant implications for healthcare policy. These included overturning Chevron deference and checking the authority of administrative law judges (ALJs). Chevron deference In its joint review of Loper Bright Enterprises v. Raimondo and Relentless, Inc. v. Department of Commerce—cases about the cost of ferrying […]
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