On March 30th, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2023 proposed Hospice Wage Index, Payment Rate Update, and Quality Reporting Requirements rule. See the fact sheet here. This proposed rule includes the annual payment and quality measure updates, and a request for feedback on health equity activities. This [...] Read More
On the evening of December 17, 2021, the Centers for Medicare & Medicaid Services (CMS) released a follow-up to its final rule, Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Final Policy Changes and Fiscal Year 2022 Rates,[1],[2] which addresses policies that were proposed but [...] Read More
On the evening of November 2, 2021, the Centers for Medicare & Medicaid Services released the CY 2022 final Physician Fee Schedule (PFS), which includes final policies for physician services covered under Medicare Part B. The rule also includes policies for telehealth services, the Quality Payment Program, and evaluation and management (E/M) visits. Provisions of [...] Read More
On July 9, 2021, the Biden Administration issued an executive order (EO), “Promoting Competition in the American Economy,” to address corporate consolidation, lack of competition and high prices for consumers, and low wages.[i] The health care portion of the EO focuses on improving competition to address health care prices and access to care in four [...] Read More
On the evening of July 1, 2021, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2022 proposed rulemaking for end-stage renal disease (ESRD). The rule includes the annual update to the ESRD prospective payment system and the ESRD Quality Incentive Program (ESRD QIP). The rule also includes proposed changes to [...] Read More
On the evening of June 28, 2021, the Centers for Medicare & Medicaid Services and the Department of the Treasury put a proposed rule on display[1] that includes rules and policies designed to promote greater access to comprehensive health insurance coverage through the Exchanges, consistent with applicable law and recent Presidential executive orders.[2],[3],[4] The proposed [...] Read More
On the evening of June 28, 2021, the Centers for Medicare & Medicaid Services (CMS) released the CY 2022 proposed payment rule for home health agencies (HHAs). This proposed rule includes the annual payment update as well as proposed policies for the quality reporting program, value-based purchasing model, and supervision requirements. This proposed rule also [...] Read More
On June 15, 2021, the Medicare Payment Advisory Commission (MedPAC) released one of their two annual Reports to Congress.[1],[2] The report includes recommendations to revise Medicare Advantage (MA) benchmark policy, streamline the portfolio of alternative payment models (APMs), replace the existing skilled nursing facility value-based purchasing program, revise indirect medical education (IME) payments, and improve [...] Read More
The Biden administration, via the Health Resources and Services Administration (HRSA) and the Department of Health and Human Services (HHS), released a proposed rule which seeks to rescind a previous final rule related to 340B discounts for insulin and injectable epinephrine that was adopted in the final months of the Trump administration. Comments on the [...] Read More
On June 15, 2021, the Medicaid and Children’s Health Insurance Program (CHIP) Payment and Access Commission (MACPAC) released one of their two annual Reports to Congress.[1],[2] The June report addresses high-cost specialty drugs in the Medicaid program; access to mental health services for Medicaid and Children’s Health Insurance Program (CHIP) enrollees; the use of EHR [...] Read More