In the health policy world, nothing gets folks like me more “excited” than expecting and then seeing a new healthcare regulation pop up in the Federal Register. While the content of the reg is usually what public stakeholders...more
2/27/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Government Efficiency (DOGE) ,
Department of Health and Human Services (HHS) ,
Executive Orders ,
Healthcare ,
Legislative Agendas ,
Medicare ,
Proposed Rules ,
Regulatory Agenda ,
Regulatory Reform ,
Rulemaking Process ,
Trump Administration
Over the next several weeks, both the Trump Administration and the 119th Congress will review the “menu” of Biden-era regulations that they may want to rescind or modify. In one of his first orders, President Trump (like...more
1/23/2025
/ Affordable Care Act ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Final Rules ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Proposed Rules ,
Regulatory Agenda ,
Trump Administration
Medicare Advantage (MA), the private insurance option under Medicare, is one of many policy areas that will garner great attention in 2025 and beyond under the incoming Trump Administration. We recently released our 2025...more
Earlier this week, Congress released the text of a continuing resolution that includes a more-robust-than-anticipated healthcare package. While the bill’s primary purpose is to keep the government open through March 14, 2025,...more
12/19/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Congressional Committees ,
Healthcare ,
Legislative Agendas ,
Medicaid ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
MIPS ,
Pharmaceutical Industry ,
Physician Fee Schedule ,
Proposed Legislation ,
Regulatory Agenda ,
Regulatory Reform ,
Telehealth ,
Telemedicine
The No Surprises Act, a law that ended the practice of “balance billing” by certain out-of-network providers, was enacted as part of the Consolidated Appropriations Act of 2021 on December 27, 2020. While the law passed...more
12/12/2024
/ Billing ,
Centers for Medicare & Medicaid Services (CMS) ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Dispute Resolution ,
Enforcement Actions ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
No Surprises Act (NSA) ,
Out of Network Provider ,
Regulatory Agenda ,
Surprise Medical Bills ,
Trump Administration
When President-elect Donald Trump is inaugurated as the 47th president of the United States on January 20, 2025, he is expected to hit the ground running. A few months into his presidency, he will likely release the fiscal...more
11/20/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Federal Budget ,
Food and Drug Administration (FDA) ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicare ,
National Institute of Health (NIH) ,
Trump Administration
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
Happy Halloween! In the health policy world, there are two things on everyone’s mind this spooky season: the upcoming election and the major calendar year (CY) 2025 Medicare fee-for-service (FFS) final regs that should be...more
10/31/2024
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Fee-for-Service ,
Health Care Providers ,
Healthcare ,
Inpatient Prospective Payment System (IPPS) ,
Legislative Agendas ,
Medicare ,
New Legislation ,
New Regulations ,
Outpatient Prospective Payment System (OPPS) ,
Regulatory Agenda ,
Telehealth ,
Telemedicine ,
Trump Administration
The election is approaching fast, and no matter who wins, there will be a change in administration come January 20, 2025. Thus, the Biden Administration is in the midst of making its final mark on priority healthcare...more
There could be an all-you-can-eat buffet of regs (and eggs) from now until the end of the year!
As you may recall, a July 2024 Regs & Eggs blog post highlighted the spring 2024 “unified agenda” that listed all the regs...more
10/17/2024
/ Biden Administration ,
Billing ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Dispute Resolution ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicare Advantage ,
Proposed Regulation ,
Regulatory Agenda ,
Regulatory Standards
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
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
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
The major calendar year proposed regs are now out, with thousands of pages of text to digest. Since a plethora of issues are embedded in these regs, including the Calendar Year (CY) 2025 Physician Fee Schedule (PFS) and the...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
A couple of weeks ago, the Centers for Medicare & Medicaid Services (CMS) released an important report that provides insight into a significant contributor of clinicians’ overall Medicare reimbursement for this year....more
A few weeks ago, Regs & Eggs focused on nine health-related issues that were not included in the Fiscal Year (FY) 2025 President’s Budget. Another policy absent from the budget was the Administration’s plan to address drug...more
4/11/2024
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Federal Budget ,
Inpatient Prospective Payment System (IPPS) ,
Legislative Agendas ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Proposed Legislation ,
Supply Chain ,
Supply Shortages
Although I previously declared January 2024 Medicare Advantage (MA) Month, this week has also been filled with news about the MA program. The Centers for Medicare & Medicaid Services (CMS) released the final rate announcement...more
4/4/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Legislative Agendas ,
Medicare ,
Medicare Advantage ,
Medicare Part C ,
Medicare Part D ,
MedPAC
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
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
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
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