Centers for Medicare & Medicaid Services

Federal Health Policy Update for January 20

The following is the latest health policy news from the federal government for the week of January 13-20.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published updates to the Healthcare Common Procedure Coding System (HCPCS) codes on the Required Face-to-Face Encounter and Written Order Prior to Delivery List.  The update adds ten codes to the list of items that require a face-to-face encounter between provider and patient and a written order prior to delivery as a condition of payment.  Go here for a summary of the update [...]

Federal Health Policy Update for January 12

The following is the latest health policy news from the federal government for January 6-12.  Some of the language used below is taken directly from government documents. Renewal of COVID-19 Public Health Emergency Declaration HHS Secretary Xavier Becerra has signed an order extending the previous declaration of a COVID-19 public health emergency.  This declaration extends the emergency to April 11.  The administration continues to assure stakeholders it will provide 60 days’ notice prior to the end of the public health emergency. MedPAC Medicare Rate Recommendations Every year MedPAC recommends to Congress rate increases for the different kinds of health care [...]

Federal Health Policy Update for January 5

The following is the latest health policy news from the federal government for December 23 through January 5.  Some of the language used below is taken directly from government documents. No Surprises Act HHS, the Department of Labor, and the Department of the Treasury have announced increases in the administrative fee for initiating the No Surprises Act’s Independent Dispute Resolution (IDR) process and for certified IDR entities.  Learn more about the administrative fee change here and about the certified IDR entity fee change here.  Both changes took effect on January 1. HHS, the Department of Labor, and the Department of the [...]

Federal Health Policy Update for December 22

The following is the latest health policy news from the federal government for the week of December 19-22.  Some of the language used below is taken directly from government documents. Congress As of this writing, Congress continues to work on an FY 2023 omnibus spending bill:  the Senate has passed it but the House has not yet addressed it.  Highlights of what negotiators have agreed to – but that have not yet been adopted – include: Preventing the additional four percent Medicare sequester for two years. Reducing by more than half the 4.5 percent cut in Medicare payments to physicians [...]

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15.  Some of the language used below is taken directly from government documents. White House The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans.  Learn more about the plan from this White House fact sheet and go here for a transcript of the White House [...]

Federal Health Policy Update for December 8

The following is the latest health policy news from the federal government for the week of December 4-8.  Some of the language used below is taken directly from government documents. No Surprises Act CMS has published an FAQ about implementation of good faith estimates for uninsured and self-pay patients under the No Surprises Act.  In the FAQ the agency explains that it will extend enforcement discretion for situations in which good faith estimates do not include expected charges from co-providers or co-facilities.  This enforcement discretion was expected to end on January 1 but CMS now writes that it will remain [...]

FEDERAL HEALTH POLICY UPDATE FOR December 1

The following is the latest health policy news from the federal government for the week of November 28 to December 1.  Some of the language used below is taken directly from government documents. 340B HHS and its Health Resources and Services Administration (HRSA) have proposed revising the current 340B administrative dispute resolution process.  Since the current process was introduced in 2020 HRSA has encountered policy and operational challenges with its implementation and now proposes revising it and is soliciting comment on its proposed new approach.  Changes include changing the nature of the dispute resolution process, using different kinds of professionals [...]

Federal Health Policy Update for November 17

The following is the latest health policy news from the federal government for the week of November 11 to 17.  Some of the language used below is taken directly from government documents. Provider Relief Fund Providers that cited extenuating circumstances for failing to submit Provider Relief Fund financial reports on time for reporting period 3 and were approved to submit their reports late must submit those late reports by December 2.  Learn more here. Centers for Medicare & Medicaid Services CMS has posted three downloadable sample formats that hospitals can use to meet federal requirements for posting in a machine-readable [...]

Federal Health Policy Update for November 10

The following is the latest health policy news from the federal government for the week of November 7 to 10.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published a notice advising teaching hospitals that they have until November 18 to ask Medicare to reconsider their per resident amounts or resident caps as shown in the Hospital Cost Report Information System (HCRIS) associated with cost reports that, as of July 1, 2022, were not reopenable.  Learn more from this CMS notice. Due to an unplanned system outage of [...]

FEDERAL HEALTH POLICY UPDATE FOR November 3

The following is the latest health policy news from the federal government for the week of October 31 to November 3.  Some of the language used below is taken directly from government documents. Medicare Payment Regulations In the past week CMS has published four regulations presenting how it will pay providers in the coming year. Outpatient prospective payment system – CMS announced a 3.8 percent increase for Medicare outpatient and ambulatory surgical payments.  It also adopted its proposal to establish rural emergency hospitals as a new kind of hospital provider; removed 11 surgical procedures from its inpatient-only list and authorized [...]

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