The CMS Interoperability and Prior Authorization Rules
Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Findings from Gibbins’ Annual Healthcare Bankruptcy Report
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Hospice and Home Health Survey Perspectives: A Conversation with Kim Skehan, VP of Accreditation at CHAP
Transparency and the Open Payments Program
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
A Very “Special” Episode: Amid Controversy, CMS Launches the Hospice Special Focus Program
Grace from CMS: Unexpected Good News on HIS and CAHPS Appeals
This Bandwagon Has a Broken Wheel: OIG Joins the Inconsistent Approach to Hospice GIP Claims
Behind the Curtain: Enhanced Provider Enrollment Oversight
Survey Woes: CMS Ramps Up Hospice Survey Program and Consequences
Inflation Reduction Act’s Drug Price Negotiation Provisions – What Now? – Diagnosing Health Care Podcast
A Glimpse Into the Other Side: Understanding the Perspective of Government Enforcers
I Understood There Would Be No Math: Audits, Extrapolations, and a New Set of Rules
Podcast: Inflation Reduction Act’s Drug Price Negotiation Provisions – What’s Next? - Diagnosing Health Care
Recently, the United States Department of Health and Human Services (“HHS”), Centers for Medicare & Medicaid Services (“CMS”), and Office of the National Coordinator for Health Information Technology (“ONC”) announced the...more
On February 8, 2024, the Centers for Medicare and Medicaid Services (CMS) released a memorandum from the Quality, Safety & Oversight Group (QSOG) updating its 2018 guidance on texting patient information among healthcare...more
Research from Guidepoint Security found that 2023 saw an 80% increase in ransomware activity year-over-year, driven in part by multiple mass exploitation campaigns impacting hundreds of organizations. In total, the report...more
On February 8, 2024, the Centers for Medicare and Medicaid Services (CMS) issued a quality standard memorandum (QSO Memo) updating and revising a memorandum it issued on January 5, 2018, to now permit the texting of patient...more
The U.S. Department of Health and Human Services (HHS) has just unveiled a proposed rule designed to penalize health care providers engaging in information blocking. Information blocking is a practice where health care...more
In coordination with the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (HHS) and Office of the National Coordinator for Health Information Technology (ONC) proposed a...more
On December 27, 2020, the Centers for Medicare & Medicaid (“CMS”) of the Department of Health and Human Services created a new provider type for embattled rural and critical access hospitals (“CAHs”)—the Rural Emergency...more
In this episode of Triage, Andrew Ruskin, Darlene Davis, and Gabriel Scott discuss key provisions associated with conversion to CMS’s new rural emergency hospital provider type. They review the purpose of the new provider...more
Effective January 1, 2023, The Joint Commission (TJC) eliminated 168 (or 14%) of its accreditation standards across all of its accreditation programs and revised 14 other standards. To further streamline its standards, TJC is...more
On January 1, 2023, Medicare began paying for services provided at Rural Emergency Hospitals (REHs), a newly created provider type established to preserve access to emergency health care in rural areas and avert closure of...more
The Centers for Medicare and Medicaid Services (“CMS”) recently released new guidance about the process for converting to a Rural Emergency Hospital (“REH”) – a new Medicaid provider type effective Jan. 1, 2023. REHs are...more
Starting July 1, 2023, The Joint Commission (TJC) will set health equity as a National Patient Safety Goal for certain TJC-accredited organizations and roll out a new Health Care Equity certification program to recognize and...more
Co-Location and the Provider-Based Rules – No News is…Good News? On July 15, the Centers for Medicare & Medicaid Services ("CMS") released the 2023 Outpatient Prospective Payment System proposed rule (“OPPS Proposed...more
Beginning in 2023, Medicare will recognize a new provider type: the Rural Emergency Hospital (REH). The establishment of REHs is intended to preserve access to emergency departments and other outpatient services in rural...more
The Centers for Medicare and Medicare Services (“CMS”) published the proposed rule for establishing Rural Emergency Hospitals on June 30, 2022. The federal assistance opportunities for these types of providers may prompt...more
Tucked into the recent proposed rule establishing Rural Emergency Hospital Conditions of Participation (CoPs) is a proposal to change the CoPs for critical access hospitals (CAHs). The Centers for Medicare & Medicaid Services...more
On June 30, 2022, the Centers for Medicare & Medicaid Services (CMS) released the long-awaited proposed rule establishing the Conditions of Participation (CoPs) that Rural Emergency Hospitals (REHs) would be required to meet...more
On April 15, 2022, the D.C. Circuit affirmed the denial of a California hospital’s request to obtain critical access hospital cost reimbursement from Medicare for the costs incurred to keep non-emergency specialty physicians...more
On October 6, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released guidance regarding the requirements and enforcement process for hospital reporting of COVID-19 data elements (the “Guidance”). The Guidance...more
On August 4, 2020, CMS proposed its annual rule adjusting the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System, as well as changes to quality reporting...more
With the growth in telemedicine, Critical Access Hospitals have a renewed interest in exploring delegated credentialing. Several years ago, the Centers for Medicare and Medicaid Services (CMS) modified the conditions of...more
To ensure Medicare beneficiaries have access to necessary care without risking exposure to COVID-19, the Centers for Medicare & Medicaid Services (CMS) has further expanded telehealth services and relaxed certain requirements...more
Hospitals across the country are questioning whether and how the Emergency Medical Treatment and Labor Act (EMTALA) requirements apply during the COVID-19 pandemic. Last week, CMS issued a list of Frequently Asked Questions...more
As part of sweeping exemptions aimed at facilitating all levels of healthcare during the coronavirus public health emergency, the Centers for Medicare and Medicaid Services (CMS) has been issuing waivers for a wide range of...more
The Centers for Medicare & Medicaid Services (CMS) allotted a blanket waiver to critical access hospitals (CAHs) of certain Medicare certification requirements to aid their response to 2019 novel coronavirus disease...more