President Biden submitted his Fiscal Year (FY) 2023 budget request to Congress on March 28, 2022. The budget request is not binding on Congress. Rather, it may serve as a guide for both Congress and the administration as they...more
4/11/2022
/ Budgets ,
Centers for Disease Control and Prevention (CDC) ,
Department of Health and Human Services (HHS) ,
Diversity ,
Food and Drug Administration (FDA) ,
Healthcare ,
HRSA ,
Mental Health ,
National Institute of Health (NIH) ,
Public Health ,
Section 340B ,
Telehealth
When COVID-19 was declared a Public Health Emergency (PHE), the Secretary of HHS was authorized to waive or modify certain Medicare, Medicaid, Children’s Health Insurance Program, HIPAA, and EMTALA requirements. Many...more
2/21/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Compliance ,
Department of Health and Human Services (HHS) ,
EMTALA ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicaid ,
Medicare ,
Public Health Emergency ,
Stark Law ,
Telemedicine
Last week, President Biden presented an outline of a $1.75 trillion Build Back Better (BBB) social spending reconciliation framework resulting from months of negotiations with House and Senate Democrats. Congressional...more
11/3/2021
/ Affordable Care Act ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Department of Veterans Affairs ,
Federal Poverty Line ,
FMAP ,
Healthcare ,
Healthcare Reform ,
Home and Community Based Services (HCBS) ,
Long Term Care Facilities ,
Medicaid ,
Medicare ,
Mental Health ,
Nursing Homes
On September 30, 2021, the Biden Administration issued the second set of implementing regulations under the No Surprises Act. The interim final rules, issued by the Departments of Health and Human Services, Labor, and...more
Last week, over seventy bipartisan members of the U.S. House of Representatives signed a letter urging CMS to reverse proposed cuts in the CY 2022 Medicare Physician Fee Schedule (PFS) proposed rule (the PFS Proposed Rule)...more
On April 1, 2021, CMS announced that it began recovering COVID-19 Accelerated and Advance Payments (CAAPs) from Medicare providers and suppliers as early as March 30, 2021. Repayments begin one year from the date CMS...more
CMS and OIG released highly anticipated final changes to the rules implementing the Stark Law, the safe harbors issued under the Anti-Kickback Statute (AKS) and the beneficiary inducements provision in the civil monetary...more
12/1/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Cybersecurity ,
Digital Health ,
DMEPOS ,
Electronic Health Record Incentives ,
Fair Market Value ,
Final Rules ,
OIG ,
Proposed Rules ,
Remuneration ,
Risk Assessment ,
Safe Harbors ,
Stark Law ,
Value-Based Care
Medicare beneficiaries will not have to pay out-of-pocket costs for coverage of monoclonal antibodies to treat COVID-19 during the public health emergency, CMS announced on November 10, 2020. The agency’s coverage will apply...more
CMS approved Georgia’s Section 1115 demonstration project to partially expand Medicaid coverage for adults not otherwise eligible for Medicaid coverage with incomes up to 95 percent of the Federal Poverty Line (FPL)—short of...more
10/23/2020
/ 1115 Waivers ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Eligibility ,
Enrollment ,
Federal Poverty Line ,
Health Insurance ,
Medicaid ,
Medicaid Work Requirements ,
Proposed Amendments ,
State and Local Government ,
Trump Administration ,
Waivers
CMS Administrator Seema Verma announced the 2019 financial and quality results for Accountable Care Organization (ACOs) in the Medicare Shared Savings Program (MSSP) in a Health Affairs Blog post on September 14, 2020. ...more
HHS announced on August 25, 2020 that, through the Health Resources and Services Administration (HRSA), HHS has awarded over $117 million in quality improvement awards to 1,318 health centers. HRSA-funded health centers...more
HHS has issued new guidance, effective July 15, changing the protocol for how hospitals are required to report COVID-19 data to the federal government. Previously, hospitals reported data to the Centers for Disease Control...more
On June 3, 2020, CMS announced changes to the Center for Medicare and Medicaid Innovation (CMMI) value-based care payment models. Notably, the changes include delaying the start date for new models that would test government...more
On March 22, 2020, CMS announced a suite of four new tools intended to help states combat the coronavirus by allowing states to streamline enrollment into long-term care and home-based services and by expediting application...more
4/1/2020
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Eligibility ,
Enrollment ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Hospitals ,
Medicaid ,
Medicare ,
OMB ,
Physicians ,
Waivers
On February 20, 2020, CMS released a proposed rule that would extend the bundled-payment model for joint replacement surgery for an additional three years and broaden its scope to include outpatient procedures (the Proposed...more
2/28/2020
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Health Care Providers ,
Hip Replacement ,
Hospitals ,
Outpatient Services ,
Payment Rates ,
Physicians ,
Proposed Rules ,
Public Comment
On December 17, 2019, Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) reintroduced legislation to address the backlog of Medicare appeals cases awaiting review before an...more
1/13/2020
/ Administrative Appeal Office ,
Administrative Appeals ,
Administrative Law Judge (ALJ) ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Medicare ,
Ombudsman ,
OMHA ,
Proposed Legislation ,
Recovery Audit Contractors (RACs) ,
Senate Finance Committee
On December 18, 2019, the Court of Appeals for the Fifth Circuit ruled that the Patient Protection and Affordable Care Act (ACA) individual mandate is unconstitutional but remanded to the district court to assess whether the...more