Source: “Table 80: Surgical Procedures Being Added to the ASC CPL in CY 2023” fromCMS’ CY2023 Medicare Hospital OPPS and ASC Payment System Final Rule. While these procedures are not related to orthopedic practice, it is important to remain cognizant of ch...
CMS Final Rule Expands Medicare/Medicaid/CHIP Provider and Supplier Screening Requirements Under Affordable Care Act AuthorityCarol Colborn Loepere
17, 2023, a final rule requiring skilled nursing facilities (SNFs) to publicly disclose additional ownership and management information. The rule mandates that SNFs participating in Medicare and Medicaid – which account for the majority of the country's SNFs – must disclose specific data related...
On August 1, 2022, the Centers for Medicare & Medicaid Services (CMS) published thefinal rulefor fiscal year (FY) 2023 Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) in the Federal Register. The regulations will take effect October 1, 2022. Each year, CMS publishes updat...
CMS also issued aseparate final ruleon November 2, 2023, to discuss payment for 340B drugs for CY 2018–2022. Some providers are receiving more than $5 million in the settlement. Actual payments can be found by provider on theCMS website. ...
CMS released the calendar year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule.
CMS has finalized policies to increase access to marketplace coverage and expand essential health benefits (EHBs) in the HHS 2025 Notice of Benefit and Payment Parameters final rule.
OnApril 17, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released the U.S. Department of Health and Human Services (“HHS”) Notice of Benefit and Payment Parameters for 2024 Final Rule (the “Notice”) that includes standards for issuers and Marketplaces, and requirements ...
Key takeaways A recent final rule outlines new rules for prior authorization and interoperability requirements impacting Medicare Advantage, Medicaid, CHIP, and Qualified Health Plans Beginning in 2026, payors will have to comply with time limit requirements on responses to prior authorization requests...
This final rule amends the requirements that Long-Term Care (LTC) facilities must meet to participate in the Medicare and Medicaid programs. Specifically, we are repealing the prohibition on the use of pre-dispute,binding arbitrationagreements. We are also strengthening the transparency of arbitrat...