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Proposed Medicare Physician Fee Schedule Would Extend Telehealth Flexibilities and Add New Coverage

The Centers for Medicare & Medicaid Services (CMS) released its annual proposed rule updating the Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2025....more

HHS Announces Medicaid and Medicare Flexibilities, Investigations post-Change Healthcare Cyberattack

Since becoming aware of the cyberattack on Change Healthcare in late February, the Centers for Medicare & Medicaid Services (CMS) has announced a number of flexibilities to support affected providers that have experienced...more

CMMI Issues Report on Status of Pending Drug Models

The Center for Medicare and Medicaid Innovation (CMMI) has provided new updates on CMS’ planned initiatives to address prescription drug costs in a blog post from Director Liz Fowler. One test, the Accelerating Clinical...more

[Webinar] Creating Provider-Sponsored Medicare Advantage Plans: Opportunities, Risks and Keys to Success - July 20th, 1:00 pm -...

Provider-sponsored plans are increasingly popular with hospitals, health systems and medical groups/independent physician associations (IPAs). Offering a plan can deliver many significant advantages to providers, enabling...more

[Webinar] The Changing Landscape of Prior Authorization for Medicare - May 23rd, 1:00 pm - 2:00 pm ET

On December 6, 2022, the Centers for Medicare & Medicaid Services (CMS) proposed a rule—the Interoperability and Patient Access final rule—that introduces new requirements for health care payers aiming to enhance patient data...more

[Webinar] Navigating the Rapidly Changing Medicare Advantage Regulatory Landscape - April 11th, 1:00 pm - 2:00 pm ET

Medicare Advantage (MA) plans now cover about half of Medicare beneficiaries, and with that enrollment growth has come increased scrutiny from federal and state regulators. As federal regulators complete a busy season of...more

[Webinar] What Will the Midterm Elections Mean for Health Care? - September 28th, 1:00 pm - 2:00 pm ET

Americans are strongly focused on the upcoming midterm elections. An NBC News survey shows that 68% of Republicans and 66% of Democrats are expressing high interest in the midterms. Which issues are most critical to voters...more

[Webinar] Implications Across the Health Care System of the New Federal Drug Price Regulation - September 22nd, 1:00 pm - 2:00 pm...

The Inflation Reduction Act of 2022 (IRA) includes the most dramatic change to U.S. drug price regulation in history. The new law allows the federal government to “negotiate” the price of many drugs dispensed to Medicare...more

[Webinar] Preparing for Change: A Guide to the Inflation Reduction Act Drug Pricing Provisions - August 23rd, 1:00 pm - 2:00 pm ET

The Inflation Reduction Act (IRA) will make arguably the most significant changes to U.S. prescription drug pricing regulations ever, but certainly since the creation of the Medicaid Drug Rebate Program in 1990. For the first...more

CMS Proposes Changes to Medicare Advantage and Part D Programs

On January 12, the Centers for Medicare & Medicaid Services (CMS) released the Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs proposed rule,...more

Year-End Appropriations Bill Includes Myriad Medicare Policy Changes

The Big Picture - Until late December, few if any Medicare policy changes were anticipated as part of a year-end healthcare package, barring extensions of funding for programs that otherwise would have expired. But after...more

New Medicare Advantage Tools Address Social Determinants of Health

Social determinants of health (SDOH) are conditions in the environments in which people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning, and quality-of-life outcomes and...more

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