Policy & Regulation News

$21M Settlement Resolves Healthcare Fraud Accusations for OH System

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Akron General Health System (AGHS), a hospital system in Ohio owned by the Cleveland Clinic Foundation, reached a civil settlement and agreed to pay $21 million for allegedly committing healthcare...

AHA’s Recommendations for Inpatient Medicare Reimbursement in FY22

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The American Hospital Association (AHA) released comments on CMS’s FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule, which would increase inpatient Medicare reimbursement rates...

CMS Proposes New Value-Based Payment for End-Stage Renal Disease

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CMS has issued a proposed rule that would create a new value-based payment pathway for end-stage renal disease (ESRD) facilities, as well as update Medicare rates for renal dialysis services next...

Biden Administration Releases Surprise Billing Regulations

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Several US departments, including HHS, have released much-anticipated surprise billing regulations to implement the No Surprises Act, a law passed last year that aims to protect patients from...

Hospitals Oppose Using Medicare, Provider Relief Funds on Infrastructure

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Leading healthcare industry groups are calling on lawmakers to leave Medicare and unspent provider relief funds alone when finding ways to offset spending from a proposed infrastructure deal. Released...

CMS Proposes $310M Boost, Value-Based Purchasing for Home Health

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CMS has released the proposed rule for the Home Health Prospective Payment System next year. The rule seeks to expand the Home Health Value-Based Purchasing (HHVBP) Model and address health equity...

New Provider Relief Fund Rules Give More Time to Use, Report Money

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HHS has updated Provider Relief Fund reporting requirements to give clinicians more time to use the payments and report on those uses. The update to the Post-Payment Notice of Reporting Requirements...

Biden Requests $133.7B for HHS Budget, Other Health Spending Plans

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President Joe Biden has requested an increase in the HHS budget next year to strengthen public health infrastructure and crisis-related needs, among other top health spending proposals. The...

Chiquita Brooks-LaSure Becomes Next CMS Administrator

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The Senate has confirmed Chiquita Brooks-LaSure to lead the Centers for Medicare & Medicaid Services (CMS) by a vote of 55 to 44. Brooks-LaSure is the first Black woman to lead the agency...

Court Orders HHS to Recalculate Medicare DGME Payments

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HHS unlawfully changed the weighting factors assigned to residents and fellows for Medicare Direct Graduate Medical Education (DGME) payments, according to a recent opinion from the US District Court...

CMS Delays Codifying Definition of “Reasonable and Necessary”

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CMS announced that it will delay the effective date of a final rule updating the definition of “reasonable and necessary” and the guidelines surrounding the Medicare Coverage of Innovative...

Lawmakers Call for Extension of Provider Relief Fund Benefits

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A bipartisan group of 77 Congress members, led by Reps. Cindy Axne (IA-03) and Mariannette Miller-Meeks (IA-02), released a letter on May 11th urging HHS to reconsider its...

CMS Proposes $2.5B IPPS Rate Hike, With Eye on Rural, Health Equity

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CMS is proposing to increase Medicare hospital inpatient rates by $2.5 billion next fiscal year, in addition to bolstering the rural healthcare workforce and health equity reporting. The rate increase...

AHA: Federal Budget Should Bolster Healthcare Workforce, Public Health

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The American Hospital Association (AHA) is asking key lawmakers to consider the potential effort their healthcare funding decisions for fiscal year (FY) 2022 will have on hospitals’ ability to...

AHA Backs Chiquita Brooks-LaSure as Next CMS Administrator

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The American Hospital Association (AHA) has announced its support of President Biden’s pick for CMS Administrator, Chiquita Brooks-LaSure, ahead of the confirmation hearing this week. The...

CMS Plans 1.3% Medicare Payment Hike for Skilled Nursing Facilities

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CMS has proposed a $444 million increase in Medicare payments to skilled nursing facilities (SNFs) in the federal fiscal year (FY) 2022, according to a new proposed rule. The rule released late...

CMS Proposes Medicare Payment Bump for Rehab, Psychiatric Facilities

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CMS has released the proposed rules for the Inpatient Rehabilitation Facility (IRF) Prospective Payment System and the Inpatient Psychiatric Facility Prospective Payment System for fiscal year (FY)...

Physician Practices Want More from Provider Relief Fund

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Future Provider Relief Fund distributions should prioritize allocation to physician practices struggling with the financial consequences of the COVID-19 pandemic, not just hospitals, physician groups...

Senate Confirms Xavier Becerra as Next HHS Secretary

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UPDATED The Senate has approved California Attorney General Xavier Becerra as the next Secretary of the Department of Health and Human Services (HHS). Senators approved Biden’s pick for the...

New Bill Seeks to Extend Medicare Sequester Moratorium

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UPDATED 04/16/2021 A bill is seeking to prevent across-the-board spending cuts triggered by the latest COVID-19 relief package, including the 2 percent Medicare sequester reduction, known as...