Policy & Regulation News

Providers Blast Medicare Spending Cuts in COVID Relief Package

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The latest $1.9 trillion COVID-19 relief package includes several provisions advantageous to healthcare providers but will leave them to face significant Medicare spending cuts in the future. Passed...

Spotlight on the Biden Administration’s Healthcare Team

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Healthcare remains one of the top priorities for the Biden administration as it inherits an ongoing pandemic and the unstable future of the Affordable Care Act. But the President is already unveiling...

Biden Administration Inherits Slew of Medicare Regulatory Changes

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Nearly all Medicare providers have been impacted by at least one COVID-19 pandemic-related regulatory change, the Commonwealth Fund reports. Under the Trump administration, there were 244 Medicare...

HHS Pushes Back Deadline for Provider Relief Fund Reporting

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HHS has amended the Provider Relief Fund reporting timeline in order to give those who received over $10,000 in payments more time to attest how they used the funds. The federal department announced...

How Biden’s COVID-19 Relief Plan Could Impact Hospitals

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Soon after the crowds disperse from the Capitol on Jan. 20, 2021, newly minted President Joe Biden will be working to enact a roughly $1.9 trillion COVID-19 relief plan that will impact hospitals and...

HHS Secretary Alex Azar Resigns, Effective Jan. 20

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Alex Azar has resigned as head of HHS to make room for President-elect Joe Biden’s pick for HHS Secretary following his inauguration on Jan. 20, 2021. Azar was sworn in as the 24th HHS Secretary...

CMS Defines “Reasonable and Necessary” Medicare Coverage

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CMS has codified how it defines “reasonable and necessary” coverage for items and services that may be covered under Medicare Parts A and B in a new final rule. The rule finalized on Jan....

Surprise Billing Arbitration Favors Providers, But Rates Are High

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An out-of-network surprise billing solution in New Jersey favors providers, paying them significantly more than in-network prices for the set of services in dispute, according to a new Health Affairs...

HHS Renews Public Health Emergency, Regulatory Flexibilities

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HHS has renewed the COVID-19 public health emergency, extending key regulatory flexibilities such as Medicare telehealth reimbursement and higher rates for COVID-19 hospitalizations through April. The...

HHS Guidance Clarifies Use of Contract Pharmacies in 340B Program

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New guidance from HHS has clarified that hospitals and other covered entities in the 340B Drug Pricing Program are entitled to discounts for covered outpatient drugs even if they use contract...

Appeals Court Throws Out Hospital Price Transparency Challenge

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A federal appeals court has recently rejected the hospital industry’s challenge of the upcoming hospital price transparency rule that will require hospitals to disclose payer-specific rates to...

UPDATED: Congress Approves COVID-19 Stimulus, Gives $3B to Provider Relief Fund

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UPDATED at 12/22/2020 Congress has reached an agreement on a $900 billion COVID-19 stimulus package that was passed on Monday evening. But healthcare providers are still concerned about receiving...

Provider Groups Leery of New Surprise Billing Legislation

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A bipartisan group of Congressmembers has struck a deal over surprise billing protections for patients, but details of the draft legislation have some providers groups concerned about the bill’s...

Bipartisan COVID-19 Relief Bill Would Add to Provider Relief Fund

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A group of bipartisan policymakers has released details on a $908 billion COVID-19 relief bill that would provide more financial support for healthcare providers. According to a summary framework...

CMS Releases 2021 OPPS Final Rule, Eliminates Inpatient Only List

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CMS has released the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rule for 2021 in an effort to give Medicare beneficiaries more choices around surgical...

CMS Finalizes 2021 Physician Fee Schedule, Including E/M Changes

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After some delay due to the COVID-19 pandemic, CMS has released the final rule for the 2021 Medicare Physician Fee Schedule. The final rule unveiled by CMS yesterday evening will dictate how much...

HHS Clarifies Debated Provider Relief Fund Reporting Requirements

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HHS is addressing Provider Relief Fund reporting requirements that have left recipients questioning how they can spend the financial aid from the federal government. The federal department clarified...

HHS Overhauls Key Healthcare Fraud Laws to Advance Value-Based Care

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After years of debate, HHS agencies have made changes to two major healthcare fraud, waste, and abuse laws that providers have said get in the way of value-based care progress. Late last week, CMS and...

VA Rule Allows Interstate Care Delivery, Promotes Care Access

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The US Department of Veterans Affairs (VA) has issued an interim final rule affirming the agency’s current policy that allows interstate care delivery for VA healthcare professionals, ultimately...

CMS Finalizes 1.9% Boost for Medicare Home Health Reimbursement

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CMS has finalized a 1.9 percent, or $390 million, increase in Medicare home health reimbursement in 2021. The boost in reimbursement is significantly less than the 2.6 percent increase proposed by CMS...