News & Analysis as of

Centers for Medicare & Medicaid Services (CMS)

Foley Hoag LLP

CMS Rescinds Post-Dobbs EMTALA Guidance, Raising New Questions for Emergency Departments

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I. Key Takeaways - Federal enforcement under the Emergency Medical Treatment and Labor Act (EMTALA) may be changing after the Centers for Medicare & Medicaid Services (CMS) rescinded guidance issued under the Biden...more

Hanson Bridgett

CMS Announces Care Compare Changes That Could Lead to Major Five-Star Impacts for Certain SNFs

Hanson Bridgett on

On June 18, Centers for Medicare and Medicaid Services published new guidance announcing a major change to the way Care Compare will display survey information and the methodology for calculating the health inspection score...more

Alston & Bird

Health Care Week in Review | Senate Finance Committee Releases Budget Reconciliation Text; SCOTUS Upholds TN Ban on...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

McDermott+

McDermott+ Check-Up – June 18, 2025

McDermott+ on

THIS WEEK’S DOSE - - Senate Finance Committee Releases Reconciliation Text. The language is subject to change as negotiations continue and the Byrd rule process plays out. - CMS Releases MA Risk Adjustment Audit Methodology...more

Sheppard Mullin Richter & Hampton LLP

Understanding the Federal Reconciliation Bill’s Implications for MCO Tax Structure

New York’s Medicaid financing strategy—particularly its use of a managed care organization (MCO) tax—has come under renewed federal scrutiny amid recent legislative proposals and regulatory developments. The federal...more

ArentFox Schiff

Private Equity Investment in Health Care Providers and Technology – 2025 Midyear Outlook

ArentFox Schiff on

As of mid-2025, private equity (PE) investors remain intensely interested in health care services and technology companies despite higher borrowing costs, heightened regulatory scrutiny, and an increasingly complex state...more

McDermott+

Inpatient Prospective Payment System (IPPS) Data Dashboard

McDermott+ on

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

McDermott+

Health Information Technology Policy Under the Trump Administration

McDermott+ on

Patient engagement. Information blocking. Interoperability. These buzz words are flying around the health information technology (HIT) world as the Trump administration starts to make its mark on the HIT policy landscape....more

Latham & Watkins LLP

Healthcare Life Sciences Drug Pricing Digest - June 2025 #2

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Some commentators are expecting that further details regarding the so-called most favored nation (MFN) pricing policy will be released in the coming days, while other sources indicate that no further information beyond a...more

McGuireWoods Consulting

Trump’s Health Care Budget Cuts: Part Three

The President’s Budget Request Impact on Programs for the Disabled and Older Americans Act Programs - This is part three of a series on health care budget cuts....more

Maynard Nexsen

Nursing Home Operators Wary of Steep Medicaid Cuts as "One Big Beautiful Bill" Moves to Senate

Maynard Nexsen on

Even as long-term care providers celebrate a proposed 10-year moratorium on the nursing home staffing mandate[1], they are sounding the alarm over major Medicaid cuts included in the House-passed budget reconciliation bill...more

DLA Piper

GAO Report Gives MA Organizations and Behavioral Health Providers Food for Thought on Prior Authorization

DLA Piper on

The US Government Accountability Office (GAO) recently released a report on the Centers for Medicare and Medicaid Services (CMS)’s oversight of prior authorization criteria for behavioral health services (BHS) by Medicare...more

McDermott+

McDermott+ Check-Up: June 13, 2025

McDermott+ on

THIS WEEK’S DOSE - - Reconciliation Moves Forward. Senate committees continue to release their reconciliation provisions. - NIH Director Testifies on FY 2026 Budget. National Institutes of Health (NIH) Director Bhattacharya...more

Alston & Bird

Health Care Week in Review | Senate HELP Committee Releases Budget Reconciliation Text; White House Issues Memo on Medicaid State...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Jones Day

Medicare's Innovation Center Charts New Direction: Part 3 – Drugs, Devices, and Data

Jones Day on

The Center for Medicare and Medicaid Innovation ("CMMI") is set to reshape value-based care. In the third of a three-part series highlighting this new direction, this summary is focused on CMMI's efforts regarding drugs,...more

Rivkin Radler LLP

CMS Rescinds EMTALA Abortion Guidance Amid Ongoing Legal Conflicts

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The Centers for Medicare & Medicaid Services (CMS) recently published a press release rescinding its June 2022 guidance concerning hospitals’ obligations to pregnant women under the Emergency Medical Treatment & Labor Act...more

Groom Law Group, Chartered

The Trump Administration Implements Aggressive Medicare Advantage Plan Audits

On May 21, 2025, the Centers for Medicare & Medicaid Services (“CMS”) announced its intent “to crush[] fraud, waste, and abuse across all federal healthcare programs” through aggressive audits of Medicare Advantage (“MA”)...more

King & Spalding

CMS Reviews Quality Standards on Gender Transition Procedures

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CMS announced in a letter released on Tuesday, May 27, 2025 (CMS Letter) that it will ramp up financial oversight of states to detect misuse of federal Medicaid funds “[t]o ensure that federal money is not used to pay for or...more

Epstein Becker & Green

CMS Doubles Down on Medicare Advantage Recoupment: Announces Aggressive RADV Strategy to Reclaim Billions

Epstein Becker & Green on

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced an aggressive plan (Plan) to expand its efforts to address fraud, waste, and abuse in Medicare Advantage (MA)....more

McDermott+

A Deep Dive Into the CMS Program Management FY 2026 Budget Request

McDermott+ on

As discussed in last week’s Regs & Eggs blog post, the US Department of Health and Human Services (HHS) recently released additional budget documents to support the department’s fiscal year (FY) 2026 discretionary request....more

Holland & Knight LLP

Holland & Knight Health Dose: June 10, 2025

Holland & Knight LLP on

The U.S. Senate will likely release additional sections of the reconciliation package this week. It is unlikely the Senate Committee on Finance, which has jurisdiction over Medicaid, will hold a markup on its portion of the...more

Latham & Watkins LLP

CMS Seeks Healthcare Industry Input on Future of Digital Health

Latham & Watkins LLP on

Comments on the RFI, due by June 16, present a rare opportunity to shape future technology standards, reporting requirements, and business opportunities....more

King & Spalding

CMS Announces Heightened Financial Oversight to Detect Misuse of Medicaid Funds Used for Immigrant Care

King & Spalding on

CMS announced in a letter released on Tuesday, May 27, 2025 (CMS Letter) that it will ramp up financial oversight of states to detect misuse of federal Medicaid funds “[t]o ensure that federal money is not used to pay for or...more

McDermott+

Health-Related Provisions in the House Reconciliation Package (June 2025 Update)

McDermott+ on

UPDATE: On June 4, 2025, the Congressional Budget Office (CBO) released updated cost estimates of H.R. 1, the One Big Beautiful Bill Act. We have updated our summary of the bill’s health provisions to reflect these new CBO...more

McDermott Will & Emery

CMS Requires Hospitals to Publish More Pricing Information, Signals Focus on Enforcement

McDermott Will & Emery on

On May 22, 2025, the Centers for Medicare & Medicaid Services (CMS) released new guidance for compliance with the hospital price transparency rule and published a request for information (RFI) seeking ways to bolster hospital...more

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