Policy & Regulation

How Policy, Regulation Will Challenge Consolidation in Healthcare

by Jacqueline LaPointe

Healthcare mergers and acquisitions have promised to bring lower costs, higher quality, and better access to care. But a new executive order is challenging the rapid pace of consolidation in...

IPPS Final Rule Bumps Hospital Reimbursement, COVID-19 Rates

by Jacqueline LaPointe

CMS has finalized an approximate $2.3 billion increase in hospital payments next year, including a 2.5 percent bump for hospital reimbursement rates under Medicare’s Inpatient Prospective Payment...

CMS Drops 4 FY22 Medicare Payment Rules: SNF, Hospice, IRF, IPF

by Jacqueline LaPointe

CMS recently released four final Medicare payment rules for fiscal year (FY) 2022. The rules cover new rates and other policies for skilled nursing facilities (SNFs), hospice agencies, inpatient...

CMS Proposes 2022 OPPS Rates, Higher Hospital Price Transparency Penalty

by Jacqueline LaPointe

CMS is seeking greater hospital price transparency enforcement through the newly proposed Medicare Outpatient Prospective Payment System (OPPS) rule for calendar year (CY) 2022. The rule proposed...

CMS Seeks Health Equity, Telehealth in Physician Fee Schedule Rule

by Jacqueline LaPointe

CMS has proposed a new rule that would update the Medicare Physician Fee Schedule and seek more health equity and telehealth utilization among physicians. The proposed rule would establish a new...

Biden’s EO on US Competition Will Impact Hospital Mergers

by Jacqueline LaPointe

An executive order has serious implications for healthcare consolidation, and specifically, hospital mergers and acquisitions. The President signed the executive order on Friday in an effort to boost...

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

by Jacqueline LaPointe

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

by Jacqueline LaPointe

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

by Jacqueline LaPointe

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

by Jacqueline LaPointe

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...

Providers Still Want More Time to Spend COVID-19 Relief Funds

by Jacqueline LaPointe

The American Hospital Association (AHA) is seeking more time for healthcare providers with unspent COVID-19 relief funds. The deadline to use COVID-19 relief funds is approaching for many providers....

HRSA: Over 5M Claims Paid for Uninsured COVID-19 Vaccinations

by Jacqueline LaPointe

The Health Resources and Services Administration (HRSA) has paid over 5 million claims for COVID-19 vaccinations of uninsured Americans, according to a recent announcement. The claims were paid...

Large Hospitals Using Price Estimator Tools for Price Transparency Rule

by Jacqueline LaPointe

The majority of the top 100 hospitals by gross revenue are using a price estimator tool to comply with a landmark hospital price transparency rule from HHS, according to a recent study. The study...

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

by Jacqueline LaPointe

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

by Jacqueline LaPointe

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

by Jacqueline LaPointe

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

by Jill McKeon

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...

Site-Neutral Payment Case Lacks Merit, HHS Tells Supreme Court

by Jacqueline LaPointe

HHS is asking the Supreme Court to bypass a case brought on by hospital groups challenging site-neutral payment rates for certain outpatient evaluation and management (E/M) services, which the...

AHA: Let Hospitals Use COVID-19 Relief Funds Through PHE

by Jacqueline LaPointe

The American Hospital Association (AHA) is asking HHS to extend the deadline for when providers can use COVID-19 relief funds to the end of the public health emergency (PHE). HHS has set a deadline of...

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

by Jacqueline LaPointe

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...