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Advisory
Member

DEA and HHS Extend Waivers for Prescribing Controlled Substances Through Telemedicine

Advisory
The Department of Health and Human Services (HHS) and Drug Enforcement Administration (DEA) Dec. 30 released a temporary rule extending for the fourth time waiver flexibilities for prescribing controlled substances via telemedicine.
Telemedicine, Prescription Drugs
Advisory
Member

CMS Issues Hospital Outpatient, Ambulatory Surgical Center Final Rule for CY 2026

Advisory
The Centers for Medicare & Medicaid Services (CMS) Nov. 21 released its calendar year (CY) 2026 outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) final rule.
Ambulatory and Outpatient Care, Post-Acute Care
Advisory
Member

Advisory on AHA Letter to Aetna on New Inpatient Payment Policy

Advisory
The AHA today urged Aetna to rescind its recently announced “level of severity inpatient payment” policy, saying that it “could erode the transparency consumers rely on to make informed decisions about their care, undermine important regulatory protections that safeguard patients’ coverage, and jeopardize the ability of hospitals to provide highquality, accessible care to all who need it.”
Reimbursement
Advisory
Member

Hospital Outpatient, Ambulatory Surgical Center Final Rule for CY 2025

Advisory
The Centers for Medicare & Medicaid Services (CMS) Nov. 1 released its calendar year (CY) 2025 outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) final rule.
Ambulatory and Outpatient Care
Advisory
Member

CMS Issues Hospital Outpatient, Ambulatory Surgical Center Final Rule for CY 2026

Advisory
The Centers for Medicare & Medicaid Services Nov. 21 released its calendar year 2026 outpatient prospective payment system and ambulatory surgical center final rule. The rule increases OPPS rates by a net 2.6% in CY 2026 compared to CY 2025.
Outpatient Prospective Payment Systems (OPPS), Ambulatory Surgical Center (ASC)
Advisory
Member

CMS Issues Proposed Rule for CY 2027 Medicare Advantage, Prescription Drug Plans

Advisory
The Centers for Medicare & Medicaid Services (CMS) Nov. 28 released its proposed Policy and Technical Changes to the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program and Programs of All-Inclusive Care for the Elderly for Contract Year (CY) 2027.
Medicare Advantage, Drug Prices, Prescription Drugs
Advisory
Member

CMS Releases CY 2026 Home Health PPS Final Rule

Advisory
The home health prospective payment system final rule for calendar year 2026 will reduce payments by 1.3%, or $220 million relative to CY 2025, according to the Centers for Medicare & Medicaid Services.
Home Health PPS, Long-term Care, Post-Acute Care
Advisory
Member

Home Health Prospective Payment System Final Rule for CY 2026

Advisory
The Centers for Medicare & Medicaid Services (CMS) Nov. 28 issued its final rule for the calendar year (CY) 2026 home health (HH) prospective payment system (PPS).
Home Health PPS, Home Health, Long-term Care, Post-Acute Care
Advisory
Member

CMS Issues IOTA Model Proposed Rule

Advisory
The Centers for Medicare & Medicaid Services (CMS) Dec. 9 issued a proposed rule that would make changes to the Increasing Organ Transplant Access (IOTA) Model beginning July 1, 2026.
Organ Transplantation
Advisory
Member

Inpatient PPS Final Rule for FY 2026

Advisory
The CMS July 31 issued its hospital inpatient prospective payment system (PPS) and long-term care hospital (LTCH) PPS final rule for fiscal year (FY) 2026.
Inpatient Prospective Payment Systems (IPPS)