On December 27, 2021, CMS finalized several Medicare graduate medical education (GME) policies, implementing changes required by the Consolidated Appropriations Act of 2021 (CAA). Importantly, the rule establishes the process CMS will use to award 1,000 new resident slots to […]
The Centers for Medicare & Medicaid Services (CMS) has finalized its outpatient prospective payment system (OPPS) and physician fee schedule rules for calendar year 2022. In the final OPPS rule, as proposed, CMS continued controversial reimbursement cuts of 30% for […]
The Centers for Medicare & Medicaid Services (CMS) has released an interim final rule (IFR) establishing the independent dispute resolution (IDR) process for surprise billing disputes and a similar process for uninsured/self-pay patients, as required by the No Surprises Act. […]
The Centers for Medicare & Medicaid Services (CMS) has released its proposed outpatient prospective payment system (OPPS) rule for calendar year 2022. To the disappointment of many in the hospital industry, the rule proposes to continue a pair of controversial […]
On July 13, 2021, the Centers for Medicare & Medicaid Services (CMS) released its proposed physician fee schedule rule for calendar year 2022, which includes provisions extending and expanding certain telehealth flexibilities, delaying the penalty phase of the appropriate use […]
On December 14, 2020, the Health and Resource Service Administration (HRSA) published a Final Rule specifying the requirements and procedures for the 340B Program’s administrative dispute resolution (ADR) process. The process was established to support covered entities and manufacturers in […]
On November 9, 2020, CMS issued a managed care rule that largely finalizes policies proposed by the agency in a November 2018 proposed rule. Among other things, the final rule would eliminate prior approval requirements for directed payments implementing minimum fee schedules based […]
On September 14, 2020, CMS administrator Seema Verma issued a tweet announcing that the agency was withdrawing the Medicaid Fiscal Accountability Rule (MFAR) from the regulatory agenda. The rule was initially released in November 2019 and remains in proposed form.
On May 11, CMS released its Proposed Inpatient Prospective Payment Rule for FY 2021. The rule includes revisions to hospital payments and quality reporting requirements.
On Friday November 15, the Trump administration released a set of rules aimed at increasing transparency in the hospital and health insurance industries. A proposed rule targeting both exchange and employer-sponsored health plans would require insurers to disclose their negotiated […]