Blog Archive

CMS Releases Proposed Rule for Skilled Nursing Facilities, Including Payment Updates & Changes to Quality Programs

On April 8th, 2021, the Centers for Medicare & Medicaid Services (CMS) released a fact sheet and unpublished proposed rule, Prospective Payment System and Consolidated Billing for Skilled…

CMS Proposes FY 2022 Payment Update for Hospices, Requests Feedback on Hospice Utilization

On the evening of April 8th, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2022 proposed rule for hospices. This proposed rule includes…

CMS Increases Payments for Inpatient Rehabilitation Facilities and Proposes Future Considerations to the Quality Reporting Program

On April 7, 2021, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for inpatient rehabilitation facilities (IRFs) for fiscal year (FY) 2022. CMS proposes…

American Rescue Plan Act of 2021 (H.R. 1319)

Congress is working on Phase 5 of coronavirus relief using the budget reconciliation process. As described by the House Committee on the Budget, “Budget reconciliation provides a fast-track…

CMS and ONC Adopt Prior Authorization Reforms and Changes to Improve the Electronic Exchange of Health Care Data (CMS-9123-F)

[vc_row][vc_column][vc_column_text]On January 15, 2021, the Centers for Medicare & Medicaid Services (CMS), working with the Office of the National Coordinator for Health Information Technology (ONC), issued a press…

CMS Looks to Expand Use of Value-Based Purchasing, Allowing for Multiple Best Prices; Clarifies Treatment of Patient Assistance and Copay Accumulators

[vc_row][vc_column][vc_column_text]In late December 2020, the Trump Administration released a final rule designed to promote the use of value-based purchasing (VBP) arrangements between drug manufacturers and payers, including Medicaid.…

HHS Proposes Modifications to the HIPAA Privacy Rule to Support Coordinated Care

[vc_row][vc_column][vc_column_text]On December 10, 2020, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) issued a press release, fact sheet, and an…

Trump Administration Finalizes Rule to Prevent PBM Rebates Almost Two Years After Initial Proposal

[vc_row][vc_column][vc_column_text]On November 20, 2020, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released a final rule that removes the existing legal safe harbor…

HHS-OIG Updates Safe Harbors Under Anti- Kickback Statute, Including Adoption of New Value-Based Framework

[vc_row][vc_column][vc_column_text]On November 20, 2020, the Health and Human Services’ Office of Inspector General (OIG) issued a fact sheet and final rule that removes potential regulatory barriers to care…

CMS Updates Physician Self-Referral Regulations to Reflect Medicare’s Transition Toward Value-Based Payment Systems

[vc_row][vc_column][vc_column_text]On November 20, 2020, the Centers for Medicare & Medicaid Services’ (CMS) issued a fact sheet and final rule to modernize and clarify regulations that interpret and implement…

CMS Updates Minimum Standards of Care for Organ Procurement Organizations, Including Revisions to Outcome Measurements (CMS-3380-F)

[vc_row][vc_column][vc_column_text]On November 20, 2020, the Centers for Medicare & Medicaid Services (CMS) released a fact sheet and final rule that updates the conditions that Organ Procurement Organizations (OPOs)…

CMS Finalizes Long-Awaited Rule that Provides Additional Flexibility for States with Medicaid & CHIP Managed Care (CMS-2408-F)

[vc_row][vc_column][vc_column_text]On the morning of November 9, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a press release, fact sheet, and a final rule that updates the…

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