Regs & Eggs
- On June 28, the Biden-Harris Administration released a Maternal Health Blueprint (Blueprint and Fact Sheet).
- On June 27, the Departments of Health and Human Services, Labor, and Treasury wrote a letter to group health plans and health issuers reminding them of their obligations under the Affordable Care Act (ACA) to provide coverage for contraceptive services at no cost.
- On June 15, ACEP responded to the Fiscal Year (FY) 2023 Inpatient Prospective Payment System (IPPS) proposed rule—the major rule impacting Medicare payments for inpatient hospital services.
- On June 27, CMS announced a new alternative payment model called the “Enhancing Oncology Model (EOM)” that is aimed at improving cancer care for Medicare patients. EOM is a voluntary model that will run from July 2023 through June 2028 and participants will include oncology practices that treat people with Medicare undergoing chemotherapy for breast cancer, chronic leukemia, lung cancer, lymphoma, multiple myeloma, prostate cancer, and small intestine/colorectal cancer.
- On June 17, CMS published a blog entitled “Pathways for Specialty Care Coordination and Integration in Population-based Models” that includes insights on increasing access to coordinated and integrated specialty care. The blog describes four major findings: 1) Providing data on specialist performance and enhancing data sharing across practices would facilitate integration with primary care; 2) Episode-based payment models can be designed to align incentives between specialists and ACO initiatives; 3) Many ACOs and primary care practices recognize value in specialty care assuming primary responsibility for special populations and beneficiaries with specific conditions; and 4) Beneficiaries with complex conditions may benefit from specialists integrated into primary care delivery pathways.
June 23, 2022 • Advocacy Info • No Surprises Act
ACEP and EDPMA Request Additional Guidance from Federal Agencies on No Surprises Act Implementation
Earlier this week, ACEP and the Emergency Department Practice Management Association (EDPMA) sent another letter related to the implementation of the No Surprises Act to federal agencies, following up...
June 2, 2022 • Advocacy Info • No Surprises Act
Ongoing Issues and Advocacy around the No Surprises Act IDR Process
As many of you know, there have been a lot of issues with the implementation of the No Surprises Act. Most of my previous blog posts have focused on the major policy disagreements that ACEP has had wi...
May 26, 2022 • Advocacy Info • Violence in the ED
Surgeon General Issues Advisory Addressing Health Worker Burnout: Gamechanger?
Regs & Eggs - May 26, 2022
May 12, 2022 • Advocacy Info • CMS Info • No Surprises Act
CMS Finalizes New Network Adequacy Requirements for Certain Private Health Plans
In a Regs and Eggs blog post from January, I discussed a promising proposal from the Centers for Medicare & Medicaid Services (CMS) to add emergency physicians to the network adequacy requirements for...
May 5, 2022 • Advocacy Info • Alternative Payment Model • CMS Info • Medicare Info
No Alternative Payment Model for Emergency Physicians and other Specialists…The AMA Has a Proposed Solution
This week’s Leadership and Advocacy Conference (LAC) was a great success! We had over 300 emergency physicians from across the country (including some of you!) come to DC and speak to legislators abou...
April 28, 2022 • Advocacy Info
ACEP’s Leadership and Advocacy Conference is Next Week! Find Out What’s on Tap!
It’s almost here! The annual Leadership and Advocacy Conference (LAC) in Washington, DC is next week, May 1 through May 3. For those of you who are unfamiliar with this conference, it allows you as e...
April 21, 2022 • Advocacy Info • ED Management
ACEP Responds to FTC and DOJ Request for Information on Mergers and Acquisitions in Health Care
Regs & Eggs - April 22, 2022
April 14, 2022 • No Surprises Act • Advocacy Info
No Surprises Act Updates Related to the “Disputed” Independent Dispute Resolution Process
To state the obvious, the first few months since the No Surprises Act has gone into effect have been a bit bumpy (and let’s face it, the period before that wasn’t so smooth either). As you all know fr...
April 7, 2022 • Advocacy Info • Opioids Info
Important Update on the “Three-Day” Rule for Administering Medications to Treat Opioid Use Disorder
As described in previous Regs and Eggs, there are many regulatory barriers to providing medication assisted treatment (MAT) to patients with opioid use disorder (OUD). Currently, physicians and other ...
March 24, 2022 • Advocacy Info • CMS Info • HHS • Medicare Info • Physician Fee Schedule
Meaningful Medicare Physician Payment Reform: Is this the year?
Many of you are all too aware of the annual song and dance the physician community has to do with Congress to avoid significant reductions to Medicare physician payments. As I noted in a previous blog...
March 10, 2022 • Advocacy Info • Violence in the ED
OSHA is Continuing to Make COVID-19 Safety Its Top Priority: At What Cost?
Like it or not, a wave of “highly focused” inspections conducted by the Occupational Safety Health Administration (OSHA) is coming.
March 3, 2022 • Advocacy Info • CMS Info • HHS • No Surprises Act
The Flawed Independent Dispute Resolution Process Has Been Fixed… For Now
As you probably all know, there has been a significant development in the legal battle over the flawed independent dispute resolution (IDR) process to resolve payment disputes for out-of-network servi...
February 24, 2022 • Advocacy Info • CMS Info • Medicare Info • MIPS Info
ACEP Provides Feedback on New Emergency Medicine Cost Measure
As I discussed in a recent Regs & Eggs blog post, the first, and only, emergency medicine cost measure is in the process of being developed by the Centers for Medicare & Medicaid Services (CMS) and it...
February 17, 2022 • Advocacy Info • Opioids Info
CDC Releases Long-Awaited Revised Opioid Prescribing Guideline: Open for Public Comment
The infamous 2016 opioid prescribing guideline is finally getting a make-over. It has been a long time coming, but the Centers for Disease Control and Prevention (CDC) finally released a draft revised...
February 10, 2022 • Advocacy Info • CMS Info • No Surprises Act
The Flip Side of the Coin: A Look at the Increase in Health Insurer Consolidation
A couple weeks ago, Regs & Eggs took a look at the significant increase in provider consolidation and the actions (or lack thereof) the federal government has taken to address this trend. I thought it...
February 3, 2022 • Advocacy Info • CMS Info • ED Management • HHS • Violence in the ED
Update on ACEP Actions to Address Physician Mental Health Needs and Wellbeing
I’m sure many of you, like me, follow Dr. Glaucomflecken on Twitter. Dr. Glaucomflecken is an ophthalmologist and comedian who posts hilarious, but extremely poignant, short videos (featuring himself)...
January 13, 2022 • Advocacy Info • CMS Info • Medicare Info
CMS Proposes Changes to Network Adequacy Requirements for Private Health Plans
Over the last couple of weeks, the Centers for Medicare & Medicaid Services (CMS) has released two regulations that update policies and payment parameters for private health plans: one impacting healt...
January 6, 2022 • Advocacy Info
A New Year: Looking Ahead at the Major Regulatory Issues Facing Emergency Physicians in 2022
Happy New Year! I hope you all were able to take some well-deserved time off and enjoy time with your friends and families during the holiday season. As we start another year, I wanted to set the stag...
December 23, 2021 • Advocacy Info • Alternative Payment Model • CMS Info • Medicare Info • MIPS Info • Physician Fee Schedule
A Request: Please Participate in the Development and Testing of the First Emergency Medicine-Specific Cost Measure
You as emergency physicians have a rare opportunity to provide input on a proposed emergency medicine-specific cost measure that will soon be tested out in the field. Before describing more about what...
December 14, 2021 • Advocacy Info • CMS Info • Medicare Info • Physician Fee Schedule
Special Edition: Congress Averts Majority of Medicare Payment Reductions, But We are not Out of the Woods Yet
Another year, another Congressional fix to Medicare physician reimbursement. Sadly, we are not out of the woods yet—and the annual song and dance with the Centers for Medicare & Medicaid Services (CMS...
December 9, 2021 • Advocacy Info • HHS • No Surprises Act
ACEP and EDPMA Officially Respond to the Extremely Flawed Second Interim Final Regulation Implementing the No Surprises Act
Earlier this week, ACEP and the Emergency Department Practice Management Association (EDPMA) submitted an official response to the second interim final regulation implementing the No Surprises Act. As...
December 2, 2021 • Advocacy Info • Alternative Payment Model • CMS Info • HHS • Medicare Info
CMS Innovation Center’s Vision for the Future: How Does ACEP’s Awesome “AUCM” Model Fit in?
Over the last few years, I have periodically updated you all on the status of the first, and only, emergency medicine-focused alternative payment model (APM), the Acute Unscheduled Care Model (AUCM)—f...
November 4, 2021 • Advocacy Info • CMS Info • Medicare Info • MIPS Info • Physician Fee Schedule • Telehealth
The 2022 Physician Fee Schedule Final Reg: Some Highlights and Perspective
Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2022 physician fee schedule (PFS) final regulation. As a reminder, this is the major annual reg th...
October 21, 2021 • Advocacy Info • CMS Info • Medicare Info • Physician Fee Schedule
Looming Medicare Payment Cuts: Will Congress come to the rescue again?
As the great Yogi Berra said, “it’s deja vu all over again.” Like last year, physicians face significant cuts under Medicare unless Congress steps in to intervene. So how did we get here? As you may r...
October 14, 2021 • Advocacy Info • Financial Support • HHS
Update on the Provider Relief Fund: Resources Still Available to Cover COVID-19 Increased Expenses and Lost Revenues
It’s been a while since I’ve provided an update on the Provider Relief Fund (PRF)—a $178 billion fund created by Congress to cover providers’ lost revenues and increased expenses due to COVID-19. Thus...