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Holland & Knight LLP

Holland & Knight Health Dose: September 10, 2024

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

Venable LLP

2025 Changes to Medicare Part D Will Impact Group Health Plans' Creditable Coverage Determination

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The Inflation Reduction Act of 2022 made significant design changes to Medicare Part D effective January 1, 2025. The changes will cause an increase in the actuarial value of Medicare Part D coverage, which will impact...more

Sheppard Mullin Richter & Hampton LLP

Attention Maryland Providers: Are You Availing Yourselves of Regulatory Flexibilities under the TCOC Model?

An April 2024 independent report (“Report”) analyzed the results of the first four years following implementation of the Maryland Total Cost of Care Model (the “TCOC Model”), finding that between 2019 and 2022 (the “TCOC...more

McDermott+

CMS Releases Final TCET Notice – Implications and Next Steps

McDermott+ on

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

Manatt, Phelps & Phillips, LLP

CMS Announces Part D Premium Parameters, New Policy to Stabilize Standalone Part D Premiums

The Centers for Medicare & Medicaid Services (CMS) released the Part D national average bid amount and Part D base beneficiary premiums for 2025. These figures set the premium costs and government subsidies for Medicare...more

Nelson Mullins Riley & Scarborough LLP

FY 2025 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS)...

On August 1, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to increase Medicare inpatient prospective payment system rates for certain acute care hospitals by a net 2.9% in fiscal year 2025, compared...more

Epstein Becker & Green

Texas Judge Sides with Challengers on CMS Rule Limiting Medicare Agent/Broker Payments

While the Supreme Court decision in Loper Bright Enterprises v. Raimondo was making headlines, other courts were considering recent regulations of another agency—the Centers for Medicare and Medicaid Services (CMS)—that are...more

Goldberg Segalla

[Webinar] Medicare Tune Up: Boosting Efficiency and Minimizing Costs - August 8th, 12:00 pm - 1:00 pm EDT

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As Medicare secondary payer penalties take effect this fall, find out what’s new, what’s on the horizon, and what to watch out for to avoid pitfalls. Join Goldberg Segalla partners Philip Unwin and Jennifer Santoro for a free...more

Manatt, Phelps & Phillips, LLP

CMS Finalizes Part D Cost-Sharing Smoothing Guidance

The Centers for Medicare & Medicaid Services (CMS) finalized the second part of its guidance on implementation of the IRA’s Medicare Prescription Payment Plan (MPPP), known informally as Part D monthly out of-pocket...more

Alston & Bird

Health Care Week in Review: CMS Releases Final Medicare Prescription Payment Plan Part 2 Guidance

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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

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - July 2024 #1

News Briefs - Texas Federal Court Ruling Puts Noncompete Ban on Hold - A Texas federal court issued a preliminary injunction against the Federal Trade Commission's noncompete ban, which if implemented would allow existing...more

Manatt, Phelps & Phillips, LLP

What States Should Know Before Applying to CMMI’s Innovation in Behavioral Health NOFO

Summary On June 17, 2024, the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services (CMS) released a notice of funding opportunity (NOFO) for Innovation in Behavioral Health...more

Manatt, Phelps & Phillips, LLP

Building a Collaborative Care Model: Lessons from Integrating Behavioral Health into Primary Care

As the national crisis in behavioral and mental health care continues to worsen, providers have tested innovative ways to bring services to children and adults in need. One approach to enhance service delivery is the...more

Manatt, Phelps & Phillips, LLP

Designing a Medicaid Hospital Global Budget Under CMS’ AHEAD Model

In September 2023, the Centers for Medicare and Medicaid Services (CMS) announced the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model, and this week CMS is expected to make a first set of...more

Manatt, Phelps & Phillips, LLP

Patient Impact of the Inflation Reduction Act - Administrative Options to Address Changed Incentives for Formulary and Utilization...

Executive Summary- The Inflation Reduction Act (IRA) makes significant changes to the Medicare Part D prescription drug benefit and also directs the Centers for Medicare and Medicaid Services (CMS) to enforce...more

Alston & Bird

Health Care Week in Review: Senate Democrats Released Draft Legislation to Prevent Labor and Delivery Unit Closures; CMS Announced...

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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

Baker Donelson

HHS Finalizes Health Care Nondiscrimination Provisions in Section 1557 Final Regulation

Baker Donelson on

The U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services and the Office of the Secretary (collectively, HHS) released the agencies' Final Rule governing the implementation of Section 1557 of...more

ArentFox Schiff

Fast Five: Important Law and Policy Updates for US Health Care Transactions

ArentFox Schiff on

With the end of the first quarter of 2024, we highlight five developments, changes, or challenges that health systems, hospitals, nursing homes, clinics, physician practices, health insurers, and other health care providers,...more

Akin Gump Strauss Hauer & Feld LLP

The Regulatory Race Is On: The Biden Administration Sprints to Issue Key Health Policies

The upcoming election, and the approaching end of the President’s four-year term, introduce additional dynamics into the agencies’ rulemaking process and even the guidance process. From now through the November election, the...more

Manatt, Phelps & Phillips, LLP

CMMI’s Innovations in Behavioral Health: Promoting Physical and Mental Well-being

Summary- On January 18, 2024, the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services (CMS) announced Innovations in Behavioral Health (IBH), a new eight-year model focused...more

Arnall Golden Gregory LLP

CMS Publishes Final Rule on Medicare Advantage Agent Broker Compensation

On April 4, 2024, the Centers for Medicare & Medicaid Services (“CMS”) published its Final Rule amending the existing Medicare Advantage (“MA”) agent broker compensation regulations. The Final Rule has significant...more

Manatt, Phelps & Phillips, LLP

CMS Restricts Marketing Companies From Sharing Medicare Beneficiary Data

Half of Medicare beneficiaries are enrolled in Medicare Advantage (MA) plans. This extensive growth, which represents a doubling of MA enrollment since 2010, has been driven in part by an extensive network of insurance agents...more

Alston & Bird

Health Care Week in Review: CMS Finalizes Rules for Medicare Advantage, Part D, and Affordable Care Act (ACA) Marketplaces

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

McDermott+

Another News-Filled Medicare Advantage Regulatory Week

McDermott+ on

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

McDermott+

CMS Releases CY 2025 Rate Announcement for Medicare Advantage and Part D

McDermott+ on

On April 1, 2024, the US Centers for Medicare & Medicaid Services (CMS) released the Announcement of Calendar Year (CY) 2025 Medicare Advantage (MA) Capitation Rates and Part C and D Payment Policies (Rate Announcement). CMS...more

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