The ICD-10-CM
The International Statistical Classification of Diseases and Related Health Problems, commonly known as the ICD, is a globally recognized system of medical data management. Developed, maintained, and copyrighted…
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Discarded drug policy moves forward
As Applied Policy reported in January, under Section 90004 of Infrastructure Investment and Jobs Act (Infrastructure Act) which was passed in November 2021, manufacturers of drugs, including biosimilar biologic products,…
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MACPAC holds September 2023 meeting
On September 21 and 22, 2023, the Medicaid and CHIP Payment and Access Commission (MACPAC) held a virtual public meeting. The meeting included sessions on denials and appeals…
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FDA releases Proposed Rule on the regulation of laboratory developed tests as medical devices
On September 29, 2023, the Food and Drug Administration (FDA) released its highly anticipated proposed rule, Medical Devices; Laboratory Developed Tests. This proposed rule aims to clarify the…
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HHS proposes rule to protect people with disabilities
On September 7th, the U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), issued the Discrimination on the Basis of Disability in…
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MedPAC holds September 2023 meeting
On September 7 and 8, 2023, the Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting. The meeting included the following sessions: Context for Medicare payment policy;…
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Current challenges in risk adjustment
As the United States transitions from a fee-for-service (FFS) model of healthcare delivery to value-based payments (VBP), both payers and providers have recognized the importance of fairly accounting…
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CMS Proposes Minimum Staffing Requirements for Long- Term Care (LTC) Facilities
On September 1st, the Centers for Medicare & Medicaid Services (CMS) issued the long-awaited Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting proposed…
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Skilled Nursing Facilities Get Four Percent Pay Bump, CMS Finalizes Quality Reporting Program Changes (CMS 1779-F)
On July 31, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2024 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Rate Update and…
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CMS Finalizes FY 2024 Inpatient Payment Policies for Hospitals, Changing Payment Rates, Limiting Physician-Owned Hospital Expansion Criteria, and Finalizing Quality Reporting Changes
On August 1, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2024 Hospital Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals and…
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Administrative Law Judges in the Office of Medicare Hearings and Appeals
Federal Administrative Law Judges (ALJs) exercise considerable authority in our national healthcare system. ALJs in the Food and Drug Administration routinely make adjudicatory decisions regarding drugs and medical…
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