This week The Centers for Medicare & Medicaid Services announced that it is lifting a suspension on hospital survey activities that was implemented during this winter's surge in COVID-19 cases and hospitalizations. An immediate resumption of...CMS Rules
The Centers for Medicare & Medicaid Services (CMS) released its proposal for the 2022 Physician Fee Schedule and Quality Payment Program rules with a focus on addressing health disparities in vulnerable communities.
Significantly, the fee schedule proposes a 3.75% cut in reimbursements to physicians in order to maintain budget...CMS Rules
The Centers for Medicare & Medicaid Services proposed a new rule last week that would impose higher penalties for large hospitals that fail to comply with price transparency rules.
From U.S. Department of Health and Human Services Secretary Xavier Becerra:
With today's proposed rule, we are simply showing hospitals through...CMS Rules
The Centers for Medicare & Medicaid Services (CMS) have recently taken steps to correct Stark Law, and released an advisory this week that applies to physician groups providing services through wholly owned subsidiary practices that are separately enrolled in Medicare.
The federal physician self-referral law, popularly known...CMS Rules
The Centers for Medicare & Medicaid Services (CMS) included provisions to expand reimbursement for telehealth services for mental and behavioral health care in the proposed 2022 Physician Fee Schedule released Tuesday. The proposal includes paying providers for audio-only services.
Telehealth use was widely expanded by CMS...
Last Thursday, the U.S. Department of Health and Human Services (HHS) issued an interim final rule that aims to protect consumers from surprise and balance billing practices and restricting out-of-pocket costs. Surprise billing was a major campaign concern for both presidential candidates and the Biden Administration is acting on...
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on Monday that will expand the home health value-based purchasing (HHVBP) model, which was originally developed by the Center for Medicare & Medicaid Innovation (CMMI) in 2016. The rule also includes updates to the Medicare Home Health Prospective Payment...CMS Rules
The Centers for Medicare & Medicaid Services (CMS) released a proposed rule last Wednesday that delays the implementation of a Trump-era rule which would incentivize the use of value-based drug pricing agreements for the Medicaid program. The original version of the regulation was finalized in December 2021, but the Biden...CMS Rules
On June 7 at 5 p.m., AHCCCS is hosting an online community forum to solicit feedback from stakeholders about the American Rescue Plan Act home and community based services expenditure enhancement.
AHCCCS will use the feedback to submit a spending plan to the Centers for Medicare and Medicaid Services by June 12 this year.
Last week, President Joe Biden announced that he would roll back a controversial Trump-era rule that would have required green card applicants and other immigrants to demonstrate that they would have health insurance upon arrival to the U.S. The so-called "public charge" rule would have allowed the government to deny visa applications if...CMS Rules
Medicare's older adults still like their coverage and report fewer cost-related problems than privately insured adults ages 50 to 64, despite receiving similar care to that age bracket.
The study from Kaiser Family Foundation said that rapidly growing healthcare spending is of concern for consumers and the relatively high prices from...
Health is both mental and physical health, and until we recognize this as a community, we will struggle to address the health of our community, according to TMC Healthcare.
The U.S. Department of Health and Human Services estimates that one in five Americans over age 18 will experience a mental health problem in a regular year. The...
The Centers for Medicare and Medicaid Services (CMS) is deep into Medicare alternative payment model (APM) revision and adjustment. One such program undergoing review is the Medicare Shared Savings Program (MSSP) and the revisions include major changes to quality reporting methodologies, the crux of the program.
CMS posted its final...CMS Rules
On Sunday, the Centers for Medicare & Medicaid Services (CMS) issued two proposed rules for inpatient and long-term care hospitals. The first aims to fund medical residency positions in hospitals in rural and underserved communities in order to address workforce shortages in those areas and would require hospitals to report COVID-19...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) issued a final rule making changes to the Comprehensive Care for Joint Replacement (CJR) payment model last week. The final rule extends the payment model for three performance years for participating hospitals and allows for CMS to test modifications to the model.
The final rule...CMS Rules
After a 1.7 billion in nursing home payment increase, the federal government is mulling several options to recalibrate the Medicare payment structure for skilled nursing facilities as it seeks to achieve its intended goal of budget neutrality, with the aim of shutting off excess payments as soon as possible.
According to the...CMS Rules
The Medicare Payment Advisory Commission (MedPAC) agreed that the Department of Health and Human Services (HHS) must put together a consolidated group of alternative payment models in order to improve demonstrations.
From the commission's recommendation:
The Secretary should implement a more harmonized portfolio of fewer spending...CMS Rules
This week, the Supreme Court suspended hearings on Medicaid work requirements as other Trump era Medicaid policies come under fire. Plus, states aren't quite meeting reporting requirements and more reporting adjustments could be on the way.
The U.S. Supreme Court suspended its review of the Medicaid work requirements and removed the...CMS Rules
Provider groups aren't too worried about the 2% Medicare payment cut that is scheduled to go back into effect on April 1st after being paused for the COVID-19 pandemic. The cuts originally went into effect in 2013 and were paused to protect providers like hospitals and doctor groups that are now confident that the cuts will continue to...CMS Rules
The American Journal of Managed Care published a study last Friday looking at the increase of outpatient knee replacement surgeries paid through private insurance after the Centers for Medicare and Medicaid Services' (CMS) decision to remove knee replacements from the Inpatient Only list.
According to the AJMC study, there was an...CMS Rules
The newly installed Biden Administration and the ongoing turbulence of the pandemic have resulted in a flurry of recent changes in the world of the Affordable Care Act—all as an impending Supreme Court decision on its very existence looms in the background.
Many Americans lost jobs due to the pandemic, and with them their...