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In-depth, actionable breakdowns of all relevant regulations and guidance

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Concise summaries of impactful policy-driving events, including congressional hearings, agency forums, and MedPAC and MACPAC sessions

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Our proprietary Issue Brief series, breaking down the status of the hottest topics in health

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RECENT ANALYSIS

CY 2021 MPFS Final Rule Finalizes Permanent Expansion of Certain COVID-19 Telehealth Flexibilities; Also Includes Changes to QPP, E/M Code Valuation, and Providers’ Scope of Practice

On December 1, 2020, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2021 Medicare Physician Fee Schedule (MPFS) final rule (fact sheet), which addresses an array of policies under Medicare Part B and the Medicare Access and CHIP Reauthorization Act (MACRA) Quality Payment Program (QPP). What it is. CMS’ major final rule affects payments to… (Slifer, December 2, 2020) #End-Stage Renal Disease, #Mental and Behavioral Health, #Mid-Level Practitioners, #Physicians, #Quality, #Telehealth, #Women’s Health

Agency Requests Information About COVID-19 Regulatory Flexibilities to Inform Permanent Changes; Comments Due Dec. 25

The Office of the Secretary within the Department of Health and Human Services (HHS) recently issued a request for information (RFI) seeking comments on the regulatory relief actions HHS has taken to respond to the COVID-19 pandemic’s impact on the health care industry. Of note, Appendix A of the RFI includes a list of 382 actions that have been taken…. (Testa, December 1, 2020) #COVID-19, #Hospitals, #Long-Term Care, #Mid-Level Practitioners, #Pharmacies, #Physicians, #Public Health, #Skilled Nursing Facilities, #Telehealth

OIG Follows Through on Rule Removing Safe Harbor Protection for Drug Rebates in Medicare Part D and Medicaid MCOs Beginning in 2022; New Safe Harbors for Point-of-Sale Discounts, PBM Services Fees Available in 60 Days

The Department of Health and Human Services Office of Inspector General (HHS OIG) issued a final rule (press release; HHS Secretary statement; fact sheet) that explicitly excludes drug rebates that manufacturers pay to pharmacy benefit managers (PBMs) and Medicare Part D plans from the current discount safe harbor, thereby eliminating their protection under the federal anti-kickback statute. The final rule… (Llamas, November 20, 2020) #Costs, #Generic Drugs, #Medicare Part D, #Pharmacy Benefit Managers, #Prescription Drugs