WASHINGTON, D.C. (June 18, 2019)—The Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) have issued a proposed rule significantly revising the nondiscrimination regulations that implemented Section 1557 of the Affordable Care Act (ACA). The revisions are intended to reduce burden, eliminate redundancy with several other nondiscriminatory regulations, and provide clarity in the application of nondiscrimination requirements.

WASHINGTON, D.C. (February 11, 2019)—The Centers for Medicare & Medicaid Services (CMS) released CMS-9115-P, the Interoperability and Patient Access Proposed Rule. The new rule outlines proposed policy changes to the MyHealthEData initiative to improve patient access to and advance electronic data exchange and care coordination throughout the health care system. CMS is also releasing two requests for information (RFIs) for feedback from providers in post-acute care settings.

ALEXANDRIA, Va. (December 3, 2018)—A new drug pricing rule (CMS-4180-P), proposed by the Centers for Medicare & Medicaid Services (CMS), released Monday, November 26, considers policies the National Community Pharmacists Association and CMS say will lower patients’ out-of-pocket costs at the pharmacy counter and lead to a more competitive and efficient Part D program.

The proposed rule eliminates administrative hurdles to providing more affordable prescription drugs and will allow Medicare to combat opioid overprescribing and abuse.

WASHINGTON, D.C. (November 20, 2017)—The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule November 16, that includes a number of changes that, if finalized, will ensure that Part D Medicare enrollees have access to more affordable prescription drugs and more robust prescription drug coverage at the pharmacy they prefer. The rule also gives health plans a new tool to combat the opioid crisis.

The leading home health organizations commend CMS for not finalizing the model.

WASHINGTON, D.C. (November 1, 2017)—The nation’s leading home health organizations, including the Partnership for Quality Home Healthcare (Partnership), the National Association for Home Care & Hospice (NAHC) and ElevatingHOME, commend the Centers for Medicare & Medicaid Services (CMS) for not finalizing the proposed Home Health Groupings Model (HHGM) in the Home Health Prospective Payment System (HHPPS) Proposed Rule for CY 2018.

Proposed rule updates geographic areas and mandatory participation requirements.

—Via CMS—WASHINGTON, D.C. (August 15, 2017)—Today, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule to reduce the number of mandatory geographic areas participating in the Center for Medicare and Medicaid Innovation’s (Innovation Center) Comprehensive Care for Joint Replacement (CJR) model from 67 to 34. In addition, CMS proposes to allow CJR participants in the 33 remaining areas to participate on a voluntary basis.

Proposed rule aims to simplify reporting requirements and offer support for doctors and clinicians in 2018.

WASHINGTON, D.C. (June 21, 2017)—The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would make changes in the second year of the Quality Payment Program as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). CMS’s goal is to simplify the program, especially for small, independent and rural practices, while ensuring fiscal sustainability and high-quality care within Medicare.

WASHINGTON, D.C. (July 7, 2016)—CMS proposed updated payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. Several of the proposed policy changes would improve the quality of care Medicare patients receive by better supporting their physicians and other health care providers.

WASHINGTON, D.C. (December 29, 2015)—CMS finalized the rule to implement Prior Authorization for general DMEPOS items. The final rule was published on December 29th. The proposed rule, published in May 2014, suggested that a prior authorization requirement be imposed for selected HCPCS that are frequently subject to unnecessary utilization. The originally proposed master list consisted of 139 HCPCS.