COVID-19 PHE Renewed

On October 13, 2022, Xavier Becerra, Secretary of Health and Human Services (HHS) announced the renewal of the public health emergency (PHE) declared due to the Coronavirus Disease 2019 (COVID-19). The PHE was originally declared on January 31, 2020; and renewed on April 21, 2020, July 23, 2020, October 2, 2020, January 7, 2021, April […]

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CMS’ Financial Incentives May Not Be Enough to Encourage Home Dialysis

Financial incentives to encourage home dialysis may be failing to produce its intended effect, according to a first-year analysis of Medicare’s End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model. This model is a multi-year, mandatory participation program created and implemented by U.S. Center for Medicare & Medicaid Innovation A random clinical trial was conducted, which […]

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Payment Rate for 340B-Acquired Drugs in 2022 OPPS Final Rule Annulled

On September 28, 2022, the United States District Court for the District of Columbia annulled the differential payment rates for 340B-acquired drugs as outlined in the 2022 Outpatient Prospective Payment Final Rule. The ruling states the Centers for Medicare and Medicaid Services (CMS) cannot apply the average sales prices (ASP) minus 22.5 percent drug payment […]

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AMA Releases CPT® 2023 Code Set

September 2022

The American Medical Association (AMA) released the 2023 CPT® code set on September 9, 2022. This code set expands upon the long-awaited modifications to E/M services for other than outpatient and office encounters, as well as several other highly anticipated changes. A total of 10,969 codes are available for 2023. 393 editorial changes were made […]

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AMA and Other Health Care Organizations Urge Senate to Extend Telehealth Policies

In a  letter to Senators last week, the American Medical Association (AMA), along with over 300 other physician, healthcare, and patient organizations, asked the Senate to extend pandemic telehealth flexibilities for at least two years following the existing statutory extension at the end of the public health emergency (PHE). Telehealth access “has been transformational—patients now […]

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AHA and AMA Withdraw Lawsuit over Enactment of No Surprises Act

The American Hospital Association (AHA) and the American Medical Association (AMA) have withdrawn their legal challenge to the No Surprises Act’s independent dispute resolution process. The lawsuit, filed in December 2021 (following the release of the September 2021 interim final rule), aimed to revise regulations pertaining to dispute negotiations between payers and providers. However, the […]

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CMS Issues FY 2023 Final Rule for Inpatient Prospective Payment System

August 2022

On August 1, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies for hospitals under the Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2023. These policies cover inpatient hospital discharges on or after October 1, 2022. Highlights are described below: CMS is finalizing their […]

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New Public Health Emergency (PHE) for Monkeypox Declared

As the number of monkeypox cases continue to rise, The Secretary of the Department of Health and Human Services (HHS) declared the monkeypox outbreak a public health emergency (PHE) on August 4, 2022, in an effort to heighten awareness and provide flexibility and funding to fight the virus’s spread. The announcement comes directly after appointment […]

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Cardiovascular Devices Lead FDA Breakthrough Device Designation

The U.S. Food and Drug Administration (FDA) stated cardiovascular devices make up the largest number of technologies accepted into the FDA Breakthrough Devices Program. Created in 2018, the Breakthrough Devices Program provides for certain medical devices to be available for patients and healthcare providers in a timely manner by speeding up their development, assessment and […]

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