Regulations and Regulatory Advocacy
The Centers for Medicare & Medicaid Services (CMS) Nov. 1 issued a final rule updating physician fee schedule (PFS) payments for calendar year (CY) 2020. The rule also includes several policies implementing year four of the quality payment program (QPP) created by the Medicare Access and CHIP…
The Centers for Medicare & Medicaid Services (CMS) Nov. 1 released the calendar year (CY) 2020 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) payment system final rule. In addition to standard updates, the rule finishes phasing in the site-neutral rate for clinic…
The Administration today released a final rule requiring hospitals to disclose payer-specific negotiated rates, along with a proposed rule that would impose new requirements on private insurers in the individual and group markets to publicly disclose negotiated rates and out-of-network allowed…
The Administration today released a final rule requiring hospitals to disclose payer-specific negotiated rates, along with a proposed rule that would impose new requirements on private insurers in the individual and group markets to publicly disclose negotiated rates and out-of-network allowed…
Improving prior authorization practices: AHA's call for timely responses, transparent appeals process, and reducing unnecessary complexity and cost.
The American Hospital Association (AHA), Association of American Medical Colleges (AAMC), Children’s Hospital Association (CHA) and Federation of American Hospitals (FAH) issued the following joint statement on today’s final rule from CMS: Today’s rule mandating the public disclosure of privately…
The Centers for Medicare & Medicaid Services Nov. 12 released a comprehensive proposed rule addressing Medicaid fiscal accountability.
The AHA, Association of American Medical Colleges and several member hospitals intend to immediately request that the U.S. District Court for the District of Columbia enforce its September ruling vacating a CMS rule reducing payments for hospital outpatient services provided in off-campus provider-…
AHA letter to CMS regarding their attention to improving health plan prior authorization processes through appropriate standardization.
A federal judge in New York today voided the Department of Health and Human Services’ 2019 final rule concerning certain statutory conscience rights in health care on lack of statutory authority and constitutional grounds.