On September 30, 2021, the Departments of Health and Human Services (HHS), Labor, and Treasury (the Departments), along with the Office of Personnel Management (OPM), released an interim final rule with comment period (IFC)...more
On September 10, the Health Resources and Services Administration (HRSA) announced $25.5 billion in new funding that will be made available to health care providers to reimburse health care related expenses and revenue losses...more
On August 4, 2021, the Centers for Medicare & Medicaid Services (CMS) published proposed changes to enforcement of the hospital price transparency rules that went into effect earlier this year. The proposed changes, part of...more
On July 2, 2021, the U.S. Supreme Court granted petitions to hear two cases related to Medicare payments for health care providers. The Court will consider a hospital appeal of a Ninth Circuit decision that vacated part of a...more
On July 1, 2021, the Departments of Health and Human Services (HHS), Labor, and Treasury (the Departments), along with the Office of Personnel Management (OPM), released an interim final rule with comment period (IFC)...more
On May 17, 2021, the Health Resources and Services Administration (HRSA) sent letters to six drug manufacturers notifying them that their actions placing restrictions on access to 340B-discounted drug prices by health care...more
Since being sworn into office on January 20, 2021, President Biden and his administration have taken several steps to advance equality for lesbian, gay, bisexual, transgender, and queer individuals (LGBTQ), including actions...more
On Friday, June 11, 2021, the Department of Health and Human Services (HHS) announced the deadlines by when health care providers must use COVID-19 Provider Relief Fund (PRF) payments and submit reports to HHS on use of...more
As part of the FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule issued on April 27, 2021, CMS intends to repeal a requirement that hospitals report their median payer-specific negotiated charges with Medicare...more
On April 13, 2021, four key lawmakers in the U.S. House of Representatives wrote to the U.S. Department of Health and Human Services (HHS) expressing concern over reports of non-compliance with hospital price transparency...more
Medicare providers and suppliers that received Medicare loans to address cash flow issues stemming from the COVID-19 public health emergency (PHE) may start seeing a reduction in Medicare reimbursement as Medicare begins to...more
Nursing homes that received Medicare loans to address cash flow issues stemming from the COVID-19 public health emergency (PHE) may soon see a reduction in Medicare reimbursement as Medicare begins to recoup a portion of...more
On March 11, 2021, President Biden signed into law the American Rescue Plan Act, a $1.9 trillion package to provide relief related to the COVID-19 public health emergency. The final legislation, which passed with support from...more
3/22/2021
/ American Rescue Plan Act of 2021 ,
Biden Administration ,
CARES Act ,
Children's Health Insurance Program (CHIP) ,
COBRA ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Grants ,
Health Care Providers ,
Health Insurance ,
Medicaid ,
Medicare ,
Mental Health ,
Public Health ,
Relief Measures ,
Rural Health Care Providers ,
Skilled Nursing Facility ,
Vaccinations
On December 21, 2020, the House and Senate passed fiscal year (FY) 2021 federal omnibus appropriations legislation that included the fifth measure passed by Congress to address the COVID-19 pandemic. In addition to providing...more
12/28/2020
/ CARES Act ,
Centers for Disease Control and Prevention (CDC) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Federal Funding ,
Financial Stimulus ,
Health Care Providers ,
Healthcare Facilities ,
Medicaid ,
Medicare ,
Popular ,
Relief Measures
On December 14, 2020, the Health Resources and Services Administration (HRSA) published in the Federal Register a final regulation to implement a 340B drug pricing program administrative dispute resolution (ADR) process. The...more
On December 2, 2020, CMS issued a Final Rule finalizing revisions to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for Calendar Year (CY)...more
On November 20, the Department of Health and Human Services (HHS) and HHS Office of Inspector General (OIG) issued a Final Rule to finalize a February 6, 2019 proposal stripping rebates received from drug manufacturers by...more
12/3/2020
/ Anti-Kickback Statute ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Manufacturers ,
Medicare Part D ,
OIG ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Rebates ,
Safe Harbors
On November 20, 2020, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule with comment period (IFC) to implement a payment model that will significantly reduce Medicare reimbursement rates for...more
12/1/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Drug Pricing ,
Health Care Providers ,
Hospitals ,
Interim Final Rules (IFR) ,
Manufacturers ,
Medicare ,
Payment Methods ,
Prescription Drugs ,
Reimbursements
On September 19, 2020, the Department of Health and Human Services (HHS) released detailed guidance outlining reporting requirements for health care providers that receive payments from the COVID-19 Provider Relief Fund...more
Members of Congress of both parties are requesting that the Department of Health and Human Services (HHS) take action to ensure that providers participating in the 340B drug pricing program can continue to receive discounted...more
The Coronavirus Aid, Relief, and Economic Security (CARES) Act provided $150 billion to the Department of Treasury to be issued to states and local governments through the Coronavirus Relief Fund (CRF), also referred to as...more
In an effort to provide beneficiaries with an increased choice of care and in another nod toward CMS' policy of increasing choice and its site neutrality initiative, CMS has proposed the elimination of the Inpatient Only...more
On July 31, 2020, the D.C. Circuit Court of Appeals issued a decision reversing a lower court decision and upholding Medicare payment cuts to certain hospitals participating in the 340B drug pricing program that have been in...more
8/20/2020
/ Administrative Authority ,
Appeals ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Hospitals ,
Medicare Part B ,
Medicare Payment Reform ,
Outpatient Prospective Payment System (OPPS) ,
Payment Rates ,
Reversal ,
Section 340B
On August 4, 2020, CMS issued a proposed rule to further reduce outpatient drug payment rates under Medicare to certain hospitals participating in the 340B drug pricing program. As part of the 2021 OPPS Proposed Rule, CMS...more
On June 23, 2020, a federal district court upheld a Centers for Medicare and Medicaid Services (CMS) regulation that requires hospitals to publicly report information regarding their standard charges, including privately...more
7/20/2020
/ Administrative Procedure Act ,
Appeals ,
Arbitrary and Capricious ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Free Speech ,
Hospitals ,
Lack of Authority ,
Penalties ,
Price Transparency ,
Reaffirmation ,
Regulatory Oversight ,
Reporting Requirements