On July 12, 2018, CMS included three proposed changes to telehealth reimbursements within the CY 2019 Physician Fee Schedule (the “Proposed Rule”). Currently, subject to certain exceptions, Medicare reimbursements for certain telehealth services are statutorily limited by the type of
CMS further crystalizes Stark liberalizations
On July 12, 2018, CMS included within the CY 2019 Physician Fee Schedule (the “Proposed Rule”) two revisions to Stark Law regulations aimed at further clarifying any actual or perceived differences between current regulations and the recently enacted Bipartisan Budget
CMS issues Pathway to Success ACO proposed rule
On August 9, 2018, CMS published the long-awaited Pathways to Success proposed rule. CMS Administrator Seema Verma published a related article on the Health Affairs Blog. The proposed rule would usher in significant changes for Accountable Care Organizations
The US Departments of HHS, Labor, and Treasury finalize expanded access to short-term, limited duration insurance
On August 1 the Departments of Treasury, Labor, and Health and Human Services (the Departments) published a final rule that will expand the availability of short-term limited duration insurance (STLDI). A Health Law Pulse summary of the proposed rule may
CMS proposes significant Medicare OPPS and ASC payment system changes for 2019
On July 25, 2018, the Centers for Medicare & Medicaid Services published its 2019 Medicare hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system proposed rule. A fact sheet describing the proposed rule is available here
GAO releases report on the differences between 340B and non-340B hospitals
On June 18, the United States Government Accountability Office (GAO) released a report on the 340B program, entitled “Drug Discount Program: Characteristics of Hospitals Participating and Not Participating in the 340B Program.” The 340B Drug Discount Program requires drug manufacturers
CMS issues CY 2019 home health proposed rule
On July 12, 2018, the Centers for Medicare & Medicaid Services (CMS) published its calendar year (CY) 2019 proposed rule for Medicare payment updates and proposed quality reporting changes for home health agencies (HHA) under the home health prospective payment
CMS issues final rule to adopt risk adjustment methodology for 2017
CMS has issued a Final Rule to adopt the risk adjustment methodology for the 2017 benefit year. The rule was issued without a notice and comment period and will become effective upon publication in the federal register. The risk adjustment
CMS opens new comment period for Kentucky HEALTH
“In light of the district court’s decision in Stewart v. Azar,” CMS has opened a new 30-day comment period for the Kentucky HEALTH demonstration project that would implement work or community engagement requirements as a condition of eligibility.
House Subcommittee on Health holds hearing on 340B program
On July 11, the U.S. House of Representatives Energy and Commerce Subcommittee on Health held a hearing on the 340B program, entitled “Opportunities to Improve the 340B Drug Pricing Program.” In his opening statement, Subcommittee Chairman Michael Burgess (R-TX) stated