On February 8, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule, Strengthening Oversight of Accrediting Organizations and Preventing Accrediting Organization Conflict of Interest, and Related Provisions. A Fact Sheet for the rule can be found here. Accrediting Organizations (AOs) are responsible for determining compliance for over 9,000 Medicare and Medicaid […]
Read MoreAdvances in technology continue to expand the promise and capabilities of medical devices. Previously limited to such basic items as bedpans, bandages, crutches, and wheelchairs, the category now encompasses technologies which were once unimaginable, including cardiac implantable electronic devices and closed loop artificial pancreas systems. As medical devices become more sophisticated, the stakes of their [...] Read More
On January 18, 2024, the Food and Drug Administration (FDA) and the Centers for Medicare & Medicaid Services (CMS) communicated an aligned stance on the regulation of laboratory-developed tests (LDTs). In a joint statement, leadership from both agencies emphasized the need for increased oversight of LDTs (i.e., tests developed and utilized within a single laboratory). [...] Read More
On January 17, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies final rule, which finalizes policies to streamline prior authorization processes for medical items and services and improve healthcare data electronic exchange standards and [...] Read More
The Healthcare Common Procedure Coding System (HCPCS, pronounced “hix-pix”) maintained by the Centers for Medicare & Medicaid Services (CMS) comprises two medical code sets, HCPCS Level I and HCPCS Level II. Level I consists of the Current Procedural Terminology© (CPT), a classification index which, as Applied Policy has previously discussed, is developed, maintained, and copyrighted [...] Read More
On Thanksgiving Day, 2023, Ardent Health Services, which owns and operates 30 hospitals and over 200 sites of care in six states, recognized that it was the victim of a ransomware attack. In response, the organization “proactively took its network offline, suspending all user access to its information technology applications, including corporate servers, Epic software, [...] Read More
On December 21, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule implementing an order from the Federal district court for the District of Connecticut in Alexander v. Azar.[1] See the fact sheet here. The rule would establish an appeals process for certain fee-for-service Medicare beneficiaries who believe hospitals incorrectly classified their [...] Read More
Doctors are among the most trusted professionals in the United States. Yet, apart from an understanding that they undergo rigorous training in medical school and endure exacting residency programs, few of us appreciate the processes through which our doctors are permitted to care for us in the hospital. In fact, completion of a medical degree [...] Read More
On November 2, the Centers for Medicare & Medicaid Services (CMS) issued the Hospital Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center (ASC) Payment Systems final rule with comment period, which finalizes updates to the OPPS and the Medicare ASC payment system for calendar year (CY) 2024. See the press release here. CMS has provided [...] Read More
On October 27, the Centers for Medicare & Medicaid Services (CMS) issued the End-Stage Renal Disease (ESRD) Prospective Payment System final rule for calendar year (CY) 2024. See the fact sheet here. This rule finalizes the following changes: Increases ESRD payment rates by 2.1 percent, Finalizes a new transitional add-on pediatric ESRD dialysis payment adjustment, [...] Read More