We are now in September! And while many folks are thinking about how summer has come and gone so quickly, those following the No Surprises Act implementation process may also be wondering how a whole year has passed since the...more
While the phrase “return to normal” is used in many different contexts, interestingly, it can now also be applied to the maximum payment adjustments that clinicians receive through the Merit-based Incentive Payment System...more
Legislative Uncertainty on Telehealth Waivers Slows Down, But Doesn’t Halt, Regulatory Action on Virtual Care McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. Click here to...more
In case you need a reminder given everything going on in Washington, DC, the Calendar Year (CY) 2025 Physician Fee Schedule (PFS) and CY 2025 Outpatient Prospective Payment System (OPPS) proposed regs were released a couple...more
We are in the midst of a storm of regulations that are being released by the Centers for Medicare & Medicaid Services (CMS) and the US Department of Health and Human Services (HHS), including the Calendar Year (CY) 2025...more
7/11/2024
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Insurance Industry ,
Legislative Agendas ,
Medicare Advantage ,
Popular ,
Proposed Regulation ,
Regulatory Agenda
The long-awaited final reg is upon us! The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) released a final regulation earlier this week...more
School is out and it is summertime, which means only one thing in the health policy community: reg season! This is the time of the year when the Centers for Medicare & Medicaid Services (CMS) releases regulations that propose...more
6/19/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Medicare ,
MIPS ,
New Regulations ,
Physician Fee Schedule ,
Physicians ,
Regulatory Agenda ,
Telehealth
Last week, the Centers for Medicare & Medicaid Services (CMS) held the second annual CMS Health Equity Conference. The event drew several hundred in-person attendees, including my colleague Kayla Holgash, and thousands of...more
6/6/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Digital Health ,
Equity ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Inpatient Prospective Payment System (IPPS) ,
Medicaid ,
Mental Health ,
Professional Conferences ,
Regulatory Agenda ,
Regulatory Reform ,
Reproductive Healthcare Issues ,
Substance Abuse
Over the last several months, the Center for Medicare and Medicaid Innovation (CMMI), within the Centers for Medicare & Medicaid Services (CMS), has introduced several alternative payment models (APMs) geared toward...more
On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) published the Medicaid and Children’s Health Insurance Program Managed Care Access, Finance, and Quality final rule. CMS finalized several substantial...more
During this election year, McDermottPlus is actively monitoring annual regulations that federal agencies are expected to release, as well as “ad hoc” regulations that will be released at the discretion of federal agencies. ...more
4/26/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
DEA ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Department of Veterans Affairs ,
Employee Benefits ,
Federal Trade Commission (FTC) ,
Food and Drug Administration (FDA) ,
Health and Welfare Plans ,
Healthcare ,
Healthcare Reform ,
New Regulations ,
OCR ,
OIG ,
OSHA ,
Proposed Regulation ,
Regulatory Agenda ,
Regulatory Reform
Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released two final regulations that added new requirements for states when operating their Medicaid programs. Medicaid is currently the largest health...more
Last week, the Centers for Medicare & Medicaid Services (CMS) released the Fiscal Year 2025 Inpatient Prospective Payment System (IPPS) proposed regulation. This 1,900+ page annual reg updates Medicare payments and policies...more
Last Sunday, Congress released the text of a minibus package, which will likely be signed into law by tomorrow. While the bill’s primary purpose is to keep the government open, it also includes healthcare extenders through...more
3/7/2024
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicare Advantage ,
New Legislation ,
New Regulations ,
Payment Systems ,
Regulatory Agenda
The U.S. is experiencing a maternal health crisis: it has one of the highest maternal mortality rates among high-income nations; increasing rates of complications from pregnancy or childbirth; and persistent disparities in...more
A few weeks ago, Regs & Eggs highlighted the major issues that McDermott+Consulting is monitoring this year – and the implementation of the president’s executive order (EO) on artificial intelligence (AI) was definitely part...more
2/1/2024
/ Artificial Intelligence ,
Biden Administration ,
Deadlines ,
Department of Health and Human Services (HHS) ,
Executive Orders ,
Health Care Providers ,
Health Information Technologies ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Machine Learning ,
New Legislation ,
ONC ,
State and Local Government ,
State Legislatures ,
Technology
On January 17, 2024, the Centers for Medicare & Medicaid Services (CMS) released a final rule that will require certain payers to automate their prior authorization processes and implement application program interfaces...more
Last week, McDermott+Consulting launched an election 2024 resource page, where you can find a 2024 health policy outlook and other insights into the November election. While regulations aren’t necessarily top-of-mind when...more
1/25/2024
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
EMTALA ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Managed Care Contracts ,
Medicare ,
Medicare Advantage ,
Medicare Part D ,
OMB ,
Pharmaceutical Industry ,
Prescription Drugs ,
Reproductive Healthcare Issues
Congress is on its way to extending the stop-gap funding bills into March (and may have already done so by the time you read this). Absent from the legislation to continue funding the federal government is a “doc fix” that...more
1/18/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
MACs ,
Medicare ,
MPFS ,
Physician Fee Schedule ,
Proposed Legislation
Happy New Year! As we enter 2024, we want to lay out some of the main regulatory issues (both new and old) that McDermott+Consulting will be tracking over the next year. While these may evolve, we think they are still...more
1/4/2024
/ Artificial Intelligence ,
CARES Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Reform ,
Laboratory Developed Tests ,
Managed Care Contracts ,
Medicaid ,
Medicare ,
MIPS ,
No Surprises Act (NSA) ,
Physician Fee Schedule ,
Proposed Regulation ,
Regulatory Agenda ,
Regulatory Reform ,
Telehealth ,
Telemedicine
As 2023 comes to a close, I can’t help but reflect on all the regulations and policies we reviewed this year (and those that we’ll continue to handle next week before the year actually ends). There were some tasty eggs with...more
12/21/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Consolidated Appropriations Act (CAA) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
No Surprises Act (NSA) ,
Physician Fee Schedule ,
Public Health Emergency ,
Regulatory Agenda ,
Telehealth
As we continue to “unwind” from the COVID-19 public health emergency (PHE), we are still very much in a transition period. Many of the policies that beneficiaries, providers, plans and states came to rely on during the...more
If you have been following the implementation of the No Surprises Act independent dispute resolution (IDR) process, you have likely seen a bunch of new rules, guidance documents and deadline extensions come out recently and...more
12/7/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Deadlines ,
Dispute Resolution ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
New Regulations ,
New Rules ,
No Surprises Act (NSA) ,
Regulatory Agenda ,
Time Extensions
It’s Thanksgiving week, so instead of eating eggs with your regs, you should sit back, relax and reflect on the regs you are thankful for as you eat your turkey legs (or whatever you enjoy on Thanksgiving). Many of the...more
11/21/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Digital Health ,
Final Rules ,
Healthcare ,
Healthcare Reform ,
Inpatient Prospective Payment System (IPPS) ,
Medicare ,
Mental Health ,
New Legislation ,
New Regulations ,
No Surprises Act (NSA) ,
Outpatient Prospective Payment System (OPPS) ,
Physician Fee Schedule ,
Regulatory Agenda ,
Telehealth
A few weeks ago, Regs & Eggs discussed the constant give and take between federal agencies and Congress as they both work on overlapping policies and objectives. The major regs released last week provide an excellent example...more
11/9/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
New Legislation ,
Outpatient Prospective Payment System (OPPS) ,
Physician Fee Schedule ,
Price Transparency ,
Proposed Legislation ,
Senate Committees ,
Telehealth ,
U.S. House