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President Donald Trump has signed an executive order that commits the Department of Health and Human Services (HHS) to taking a series of regulatory and subregulatory actions intended to enhance [...]

Preliminary 2020 Medicare clinical laboratory fee schedule (CLFS) payment determinations for new and reconsidered clinical lab test codes are now available for review. For each code, the Centers for Medicare [...]

On September 25, 2019, the House Energy and Commerce Committee is holding a hearing entitled 'Making Prescription Drugs More Affordable: Legislation to Negotiate a Better Deal for Americans.' A background [...]

The Centers for Medicare & Medicaid Services (CMS) has published its final rule to update the Medicare inpatient rehabilitation facility (IRF) prospective payment system (PPS) for fiscal year (FY) 2020. [...]

The Centers for Medicare & Medicaid Services (CMS) will increase Medicare inpatient psychiatric facility (IPF) prospective payment system (PPS) payments by 1.5%, or $65 million, in fiscal year (FY) 2020 [...]

The Centers for Medicare & Medicaid Services (CMS) has proposed updating Medicare end-stage renal disease (ESRD) prospective payment system (PPS) rates by 1.7% for calendar year 2020. This update reflects [...]

The Centers for Medicare & Medicaid Services (CMS) has published its final rule updating the Medicare skilled nursing facility (SNF) prospective payment system (PPS) for fiscal year (FY) 2020, which [...]

The Centers for Medicare & Medicaid Services (CMS) has proposed simplifying and streamlining long-term care (LTC) facility rules and survey processes to 'increase provider flexibility and reduce excessively burdensome regulations, [...]

The House of Representatives has overwhelmingly approved H.R. 3253, the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act, which would finance extension of various Medicaid-related health programs by increasing manufacturer [...]

The Centers for Medicare & Medicaid Services (CMS) is revoking the authority of states to 'divert' certain Medicaid provider payments to a third party (rather than make the payment directly [...]

Medical equipment suppliers can submit bids for Round 2021 of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) from July 16 through September 18, [...]

Recent Congressional hearings and markups have concentrated on prescription drug pricing, insurance access, and other health topics. For instance, last week the House Ways and Means Committee unanimously approved H.R. [...]

The House and Senate have both approved H.R. 1839, the Medicaid Services Investment and Accountability Act of 2019, clearing it for President Trump's signature. Notably, the legislation would: subject drug [...]

The Centers for Medicare & Medicaid Services (CMS) recently revised its guidance to states on standards for citing 'immediate jeopardy' during surveys of all provider and supplier types and laboratories, [...]

The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) have proposed updates to the Clinical Laboratory Improvement Amendments of 1988 (CLIA) proficiency [...]

As the new 116th Congress gets underway, four House and Senate committees are holding hearings to examine health policy issues, including two hearings focusing on prescription drug prices. Specifically, the [...]

The Department of Health and Human Services (HHS) is proposing to rescind the standard unique health plan identifier (HPID) and the other entity identifier (OEID), along with related implementation specifications [...]

Medicare end-stage renal disease (ESRD) prospective payment system (PPS) payments are expected to increase by 1.6% - or about $210 million - in calendar year (CY) 2019 under the final [...]

As part of the Trump Administration's fall regulatory agenda, the Department of Health and Human Services (HHS) emphasizes its commitment to 'reducing and streamlining its regulations and improving the transparency, [...]

The Centers for Medicare & Medicaid Services (CMS) has proposed revising its rules governing the process Medicare beneficiaries, providers, and suppliers use to appeal adverse determinations regarding claims for Medicare [...]

The Centers for Medicare & Medicaid Services (CMS) has provided additional guidance on a hospital price transparency policy that goes into effect January 1, 2019. By that date, hospitals must [...]

The Centers for Medicare & Medicaid Services (CMS) is holding a Town Hall Meeting on December 4, 2018 to discuss fiscal year (FY) 2020 applications for add-on payments for new [...]

The House of Representatives approved two 'gag clause' bills on September 25, 2018 that would prevent insurers from restricting pharmacies from informing consumers about lower cost, out-of-pocket prices for their [...]

CMS has issued a proposed rule intended streamline the Medicare and Medicaid regulatory burden on numerous types of providers and suppliers. CMS generally classifies the proposals as falling into the [...]

CMS is hosting an October 5, 2018 'Provider Compliance Focus Group' meeting to address several Medicare fee-for-service compliance topics, including the Recovery Audit Contractor (RAC) and targeted probe and educate [...]

CMS has released the inflation-adjusted de minimis Open Payments/Physician Payments Sunshine Act reporting thresholds for 2019. Payments or other transfers of value of less than $10.79 do not need to [...]

The Centers for Medicare & Medicaid Services (CMS) expects Medicare payments to inpatient rehabilitation facilities (IRFs) to increase by 1.3% ($105 million) in fiscal year (FY) 2019 under the final [...]

The House of Representatives has voted 283 - 132 to approve legislation (HR 184) that would permanently repeal the Affordable Care Act's 2.3% excise tax on the sale of certain [...]

CMS has published its final rule to update fiscal year (FY) 2019 rates and policies for Medicare inpatient psychiatric facility (IPF) services. CMS estimates that the final rule will increase [...]

The Centers for Medicare & Medicaid Services (CMS) has finalized its FY 2019 update to Medicare hospice rates and policies. As forecast in the May 8, 2018 proposed rule, CMS [...]

The Centers for Medicare & Medicaid Services (CMS) has determined that it should extend for an additional six months its current moratoria on the Medicare, Medicaid, and Children's Health Insurance [...]

On August 15, 2018, CMS is convening a Special Open Door Forum on 'Sharing Federal Strategies to Address the Opioid Epidemic.' The conference call, which will feature representatives from several [...]

CMS is inviting stakeholders to participate an August 22, 2019 listening session on the CY 2019 proposed Medicare physician fee schedule rule. The call will focus on three aspects of [...]

CMS has issued its proposed rule to update Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System rates and policies for calendar year (CY) 2019. [...]

The House Energy and Commerce Committee has scheduled three hearings this week on health topics: A July 24 hearing on advertising and marketing practices within the substance use treatment industry; [...]

Congressional committees have held numerous hearings and markups in recent weeks on health policy topics, including several hearings focused on health care costs. Highlights include the following: The Senate Health, [...]

Agency Anticipates Temporary Lapse in Competitive Bidding Program after 2018 CMS is proposing a number of changes to Medicare durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) reimbursement policies for [...]

The Medicare Payment Advisory Commission (MedPAC) has released its annual report to Congress on 'Medicare and the Health Care Delivery System.' This year's report includes recommendations for changes to emergency [...]

The Centers for Medicare & Medicaid Services (CMS) has proposed its annual update to Medicare home health prospective payment system (HHS PPS) rates for calendar year 2019, along with a [...]

The House Ways and Means Health Subcommittee has scheduled a July 17, 2018 hearing on 'Modernizing Stark Law to Ensure the Successful Transition from Volume to Value in the Medicare [...]

CMS is planning a new 'Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration' that would allow clinicians who participate in certain Medicare Advantage (MA) plans that involve taking on risk [...]

The House of Representatives has overwhelmingly approved bipartisan legislation, HR 6, the SUPPORT for Patients and Communities Act, intended to bolster opioid prevention and treatment programs and strengthen law enforcement [...]

Citing an interest in improving its processes and eliminating unnecessary requirements, CMS is hosting July 13, 2018 'Provider Compliance Focus Group' meeting regarding Medicare fee-for-service compliance topics, including medical review, [...]

As part of its 'Regulatory Sprint to Coordinated Care,' the Centers for Medicare & Medicaid Services (CMS) is seeking input on how it can address 'unnecessary obstacles to coordinated care, [...]

The Trump Administration has launched a high-profile initiative aimed at reducing prescription drug prices, including release of a blueprint containing a series of short- and long-term policy proposals and a [...]

Congress is considering a wide range of legislative proposals that seek to address the continuing opioid crisis. The following committees have tackled this topic recently: Senate Committee on Health, Education, [...]

In addition to the numerous hearings and markups on the opioid crisis discussed in a separate post, Congressional committees are examining the following health policy topics: The Senate Committee on [...]