Deborah Godes

Deborah Godes

McDermott Will & Schulte

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CMS releases CY 2026 Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System final rule

On November 21, 2025, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final...more

11/25/2025  /  Ambulatory Surgery Centers , Centers for Medicare & Medicaid Services (CMS) , Final Rules , Healthcare Facilities , Hospitals , Medicare , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Price Transparency , Reporting Requirements , Section 340B

The wait is over: The CY 2026 OPPS final rule is finally here

Last Friday (November 21), the Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2026 Outpatient Prospective Payment System (OPPS) final rule, the major Medicare payment rule impacting hospital...more

11/25/2025  /  Ambulatory Surgery Centers , Centers for Medicare & Medicaid Services (CMS) , Comment Period , Final Rules , Health Care Providers , Hospitals , Medicaid , Medicare , Medicare Part B , Outpatient Prospective Payment System (OPPS) , Physicians , Rulemaking Process , Section 340B , Site-Neutral Exception

A Halloween “treat”: CMS issues CY 2026 Medicare Physician Fee Schedule final rule

McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. November 4, 2025 – Trick or treat! On Halloween evening, the Centers for Medicare & Medicaid Services (CMS) spooked all of us...more

11/5/2025  /  Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Fee-for-Service , Final Rules , Health Care Providers , Medicare , Medicare Access and CHIP Reauthorization (MACRA) , Medicare Part B , Payment Systems , Physician Fee Schedule , Physicians , Popular , Public Health Service Act , Regulatory Oversight , Rulemaking Process , Telehealth

CMS releases CY 2026 Physician Fee Schedule final rule

On October 31, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS) final rule, which includes policies related to Medicare physician payment and...more

11/3/2025  /  Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Final Rules , Medical Devices , Medicare , Medicare Shared Savings Program , MIPS , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Telehealth

Blurred lines: Reactions to site neutral and site neutral lite policies

McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. September 25, 2025 – We’ve enjoyed a buffet of comments on regs (and eggs) recently. In our last post, we discussed comments...more

9/25/2025  /  Ambulatory Surgery Centers , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Hospitals , Medical Devices , Medicare , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Proposed Rules , Regulatory Oversight

CMS proposes RPM reimbursement updates, requests information on reimbursing for SaaS

Over the past several years, the Centers for Medicare & Medicaid Services (CMS) has expanded payment for remote monitoring services in an effort to recognize and pay for non-face-to-face services that improve care management...more

8/6/2025  /  Centers for Medicare & Medicaid Services (CMS) , Comment Period , Digital Health , Healthcare , Healthcare Reform , Medical Devices , Medicare , Physician Fee Schedule , Proposed Rules , Reimbursements , SaaS , Telehealth

Site neutrality is on the menu in the CY 2026 Medicare Outpatient Prospective Payment System proposed rule

Last week, the Centers for Medicare & Medicaid Services (CMS) issued two major regs: the calendar year (CY) 2026 Medicare Physician Fee Schedule (PFS) proposed rule and the CY 2026 Outpatient Prospective Payment System (OPPS)...more

7/24/2025  /  Centers for Medicare & Medicaid Services (CMS) , Healthcare , Healthcare Reform , Hospitals , Legislative Agendas , Medicare , Outpatient Prospective Payment System (OPPS) , Payment Systems , Physicians , Proposed Rules , Regulatory Agenda , Regulatory Requirements , Trump Administration

CMS releases CY 2026 Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System proposed rule

On July 15, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Proposed Rule [CMS-1834-P],...more

7/18/2025  /  Ambulatory Surgery Centers , Centers for Medicare & Medicaid Services (CMS) , Financial Services Industry , Healthcare , Healthcare Reform , Medicare , Outpatient Prospective Payment System (OPPS) , Payment Systems , Proposed Rules , Regulatory Requirements , Reporting Requirements

CMS releases CY 2026 Physician Fee Schedule Proposed Rule

On July 14, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B [CMS-13271]...more

7/17/2025  /  Ambulatory Surgery Centers , Centers for Medicare & Medicaid Services (CMS) , Healthcare , Healthcare Reform , Insurance Industry , Medicare , Medicare Part B , Medicare Shared Savings Program , New Regulations , Physician Fee Schedule , Proposed Rules , Regulatory Agenda , Technology , Telehealth

Inpatient Prospective Payment System (IPPS) Data Dashboard (UPDATED)

What is the cost of a knee implant in the inpatient setting? How much does Medicare pay for different types of cardiac valve procedures? How have Medicare inpatient volumes changed over time for inpatient hip and femur...more

6/25/2025  /  Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Healthcare Costs , Healthcare Facilities , Hospitals , Inpatient Prospective Payment System (IPPS) , Life Sciences , Medical Devices , Medicare , Payment Systems

Inpatient Prospective Payment System (IPPS) Data Dashboard

Updated to include Medicare claims data thru Q4 2024. What is the cost of a knee implant in the inpatient setting? How much does Medicare pay for different types of cardiac valve procedures? How have Medicare inpatient...more

6/18/2025  /  Centers for Medicare & Medicaid Services (CMS) , Healthcare , Healthcare Costs , Healthcare Facilities , Healthcare Reform , Hospitals , Inpatient Prospective Payment System (IPPS) , Medical Devices , Medicare , Payment Systems , Reimbursements

Inpatient Prospective Payment System (IPPS) Data Dashboard

Updated to include Medicare claims data thru Q3 2024. What is the cost of a knee implant in the inpatient setting? How much does Medicare pay for different types of cardiac valve procedures? How have Medicare inpatient...more

4/17/2025  /  Centers for Medicare & Medicaid Services (CMS) , Data Collection , Healthcare , Healthcare Costs , Healthcare Facilities , Healthcare Reform , Hospitals , Inpatient Prospective Payment System (IPPS) , Medical Devices , Medicare , Reimbursements

CMS Releases FY 2026 Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule

On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2026 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment...more

4/16/2025  /  Centers for Medicare & Medicaid Services (CMS) , Healthcare , Healthcare Facilities , Hospitals , Medicare , Payment Systems , Proposed Legislation , Proposed Rules , Regulatory Requirements , Reporting Requirements

Inpatient Prospective Payment System (IPPS) Data Dashboard

Updated to include Medicare claims data thru Q2 2024. What is the cost of a knee implant in the inpatient setting? How much does Medicare pay for different types of cardiac valve procedures? How have Medicare inpatient...more

3/7/2025  /  Centers for Medicare & Medicaid Services (CMS) , Health Insurance , Hospitals , Inpatient Prospective Payment System (IPPS) , Medical Devices , Medicare

Another Trip to the Buffet: Highlights from the CY 2025 OPPS Final Reg

As mentioned last week, the Centers for Medicare & Medicaid Services (CMS) recently put out a large buffet of regs – too many to digest in one blog post. While we focused on the Calendar Year (CY) 2025 Physician Fee Schedule...more

11/14/2024  /  Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Healthcare , Healthcare Reform , Legislative Agendas , Medicare , New Regulations , Outpatient Prospective Payment System (OPPS) , Pharmaceutical Industry , Physician Fee Schedule , Regulatory Agenda , Telemedicine

CMS Releases CY 2025 Hospital Outpatient Prospective Payment and ASC Payment Systems Final Rule

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2025 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Final Rule [CMS-1809-F],...more

11/6/2024  /  Ambulatory Surgery Centers , Centers for Medicare & Medicaid Services (CMS) , Final Rules , Health Care Providers , Healthcare , Outpatient Prospective Payment System (OPPS) , Payment Systems , Regulatory Requirements

CMS Releases CY 2025 Physician Fee Schedule Final Rule

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2025 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more

11/6/2024  /  Centers for Medicare & Medicaid Services (CMS) , Final Rules , Health Care Providers , Hospitals , Medicare , MIPS , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Physicians

Physician Fee Schedule Payment System Data Dashboard

Have Medicare physician fee-for-service payment rates increased for X-ray services? How have remote patient monitoring prices evolved over the last five years? How much is your service paid in Alaska compared to Alabama?...more

11/6/2024  /  Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Payment Systems , Physician Fee Schedule

Hospital Outpatient Prospective Payment System Data Dashboard

What are the cost drivers for different ambulatory services? How much does Medicare pay for outpatient knee replacements? How has Medicare volume changed over time for outpatient GI procedures? ...more

11/6/2024  /  Ambulance Providers , Centers for Medicare & Medicaid Services (CMS) , Hospitals , Medicare , Outpatient Prospective Payment System (OPPS) , Regulatory Requirements

OIG Recommends Additional Oversight of Remote Monitoring Services

On September 24, 2024, the Office of Inspector General (OIG) at the US Department of Health and Human Services issued a report recommending additional oversight of remote physiologic monitoring (RPM) services furnished to...more

9/27/2024  /  American Medical Association , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Medical Monitoring , OIG , Regulatory Requirements

CMS Releases Final Procedural Notice on Transitional Coverage for Emerging Technology (TCET)

The Centers for Medicare & Medicaid Services (CMS) issued the final procedural notice on Transitional Coverage for Emerging Technologies (TCET), effective as of August 12, 2024. TCET is a new pathway that uses existing...more

8/20/2024  /  Centers for Medicare & Medicaid Services (CMS) , Food and Drug Administration (FDA) , Insurance Industry , MACs , Manufacturers , Material Adverse Change Clauses (MACs) , Medicare , Public Comment , Technology Sector

CMS Releases Final TCET Notice – Implications and Next Steps

Last week, the Centers for Medicare & Medicaid Services (CMS) issued a final procedural notice for the new Transitional Coverage for Emerging Technologies (TCET) pathway for certain US Food & Drug Administration (FDA)...more

8/15/2024  /  Centers for Medicare & Medicaid Services (CMS) , Emerging Technologies , Food and Drug Administration (FDA) , Health Insurance , Healthcare , Legislative Agendas , Medical Devices , Medicare , New Legislation , Regulatory Agenda

CMS Releases FY 2025 Hospital Inpatient Prospective Payment System (IPPS) Final Update

On August 1, 2024, the Centers for Medicare & Medicaid Services (CMS) posted the Hospital Inpatient Prospective Payment System (IPPS) final update for fiscal year (FY) 2025, along with proposed policy and regulation changes....more

8/6/2024  /  Centers for Medicare & Medicaid Services (CMS) , Final Rules , Health Care Providers , Healthcare , Hospitals , Inpatient Prospective Payment System (IPPS) , Medicare , Payment Systems

Coding Update: CPT Editorial Panel Meeting: What's on the Agenda and Why It Matters

The CPT® Editorial Panel will meet in Albuquerque, New Mexico, from September 19 to 21, 2024. As published by the American Medical Association (AMA), the meeting agenda includes proposals to create new current procedural...more

7/24/2024  /  American Medical Association , Coding , Health Care Providers , New Regulations , Policies and Procedures , Regulatory Requirements

CMS Releases CY 2025 Hospital Outpatient Prospective Payment and ASC Payment Systems Proposed Rule

On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more

7/17/2024  /  Centers for Medicare & Medicaid Services (CMS) , Outpatient Prospective Payment System (OPPS) , Payment Systems
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