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Archive Tag: medicare

CMS Finalizes CY 2023 Policy Changes for Medicare Advantage and Part D Plans; Including Patient Cost-Sharing, Patient Protections, and Provider Accessibility

On April 29, 2022, the Centers for Medicare & Medicaid Services (CMS) released its final rule and a fact sheet, containing policies for Medicare Advantage (MA) and Medicare Part D plans in CY (contract year) 2023. The rule includes the following changes: Redefining ‘negotiated price’ for Part D drugs so prices at point of sale [...] Read More

CMS Finalizes Physician Fee Schedule for Upcoming Calendar Year 2022

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

White House Releases Full Budget Request for Fiscal Year 2022

On May 28, 2021, the White House released the President’s fiscal year (FY) 2022 budget.[1] This full version of the budget follows the Administration’s “top-line” budget released in early April. For the Department of Health and Human Services (HHS), the administration is requesting $131.8 billion in discretionary.[2] In a statement about the budget request HHS [...] Read More

CMS Proposes FY 2022 Payment Policies for Hospitals, Extending Add-on Payments, Adding GME Slots, and Repealing Market-Based Data Collection

On the evening of April 27, 2021, the Centers for Medicare & Medicaid Services (CMS) released its proposed 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 (link), which updates the FY 2022 payment systems and [...] Read More

CMS Proposes Payment Policies for Inpatient Psychiatric Facilities in FY 2022

On the evening of April 7th, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2022 proposed rule for inpatient psychiatric facilities (IPFs), which includes proposed policies for payment and quality reporting in these facilities. Comments on the proposed rule are due on June 7, 2021. CMS Predicts Increase in IPF [...] Read More

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

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) must meet in order to have their services covered by Medicare and Medicaid. Fifty-eight OPOs operate in the U.S. as not-for-profit organizations responsible for recovering organs from [...] Read More

HHS Makes Moves in the Kidney Space: CMS Releases ESRD ETC Model and HRSA Removes Disincentives to Organ Donation

On September 18, 2020, the Centers for Medicare & Medicaid Services (CMS) released its long-awaited Specialty Care Models to Improve Quality of Care and Reduce Expenditures final rule (link) and the Health Resources and Services Administration (HRSA) released its Removing Financial Disincentives to Living Organ Donation final rule (link) and updated guidelines (link). These rules [...] Read More

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