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Health Industry Washington Watch Blog

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CMS Releases Proposed Medicare Advantage and Part D Rules for Contract Year 2021 and 2022

USA - February 17 2020 CMS has put on display a proposed rule that would update Medicare Advantage (MA) and Medicare Part D prescription drug benefit policies for contract…

HHS Adopts New Retail Pharmacy HIPAA Transaction Requirements for Schedule II Drug Prescriptions

USA - February 17 2020 The Department of Health and Human Services (HHS) has modified HIPAA retail pharmacy transaction requirements to differentiate between partial fill…

CMS Proposes Updates to ACA Exchange Plan Policies for 2021

USA - February 17 2020 The Centers for Medicare & Medicaid Services (CMS) has proposed updates to its standards for health plan issuers offering plans through…

CMS Proposes 2021 Funding Methodology for ACA Basic Health Program

USA - February 13 2020 The Centers for Medicare & Medicaid Services (CMS) has released the methodology and data sources it proposes to use to determine federal payment to…

CMS Updates List of DMEPOS Items Subject to Medicare Prior Authorization

USA - February 13 2020 CMS is adding six types of lower limb prosthetics to the list of equipment subject to Medicare prior authorization (PA) requirements, and extending…

Trump Administration Offers States New Medicaid “Healthy Adult Opportunity” Demonstration with Enhanced Benefit, Payment Flexibilities

USA - February 3 2020 The Centers for Medicare & Medicaid Services (CMS) has announced a controversial plan to allow states to apply to participate in a new Medicaid…

HHS Sustains Digital Health Momentum and Continues Publishing Policy Initiatives to Kick-off 2020

USA - January 30 2020 The U.S. Department of Health and Human Services (HHS) started the new decade by keeping up its momentum to encourage patient engagement and support…

CMS Wants Input on Role of Out-of-State Medicaid Providers in Coordinating Care for Children with Medically Complex Conditions

USA - January 17 2020 The Centers for Medicare & Medicaid Services (CMS) has released a Request for Information (RFI) on how the Medicaid program can incorporate…

HHS Boosts Civil Monetary Penalties Again

USA - January 17 2020 The Departments of Health and Human Services (HHS) has just published its “annual” inflation update to civil monetary penalty amounts (CMP) in its…

HHS Continuing to Reduce Medicare ALJ Appeals Backlog under Court Order; Senators Reintroduce Legislation Striving to Improve Efficiency of Medicare Appeals Process

USA - January 16 2020 The Department of Health and Human Services (HHS) is ahead of schedule to reduce its Medicare Administrative Law Judge (ALJ) appeals backlog, as…