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.
March 17, 2022 • CMS Info • Financial Support • HHS • Medicare Info • Telehealth
Unwinding from the COVID-19 Pandemic: Implications for Emergency Physicians and Patients
Lately, we seem to be hearing loud and clear from many people (including government officials) that they are ready to move on from the COVID-19 pandemic. However, in the regulatory world, what exactly...
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...
July 8, 2021 • Advocacy Info • HHS • Financial Support • No Surprises Act
The Biden Administration Issues First Regulation Implementing the No Surprises Act: Highlights and Some Perspective
The health policy community got a special gift right before the start of the July Fourth weekend. Last Thursday, July 1st, the Departments of Health and Human Services (HHS), Treasury, and Labor (refe...
April 22, 2021 • Advocacy Info • ED Management • Financial Support
Emergency Department Visits Still Down Compared to Pre-Pandemic Levels
As most of you know, emergency department (ED) visits significantly fell last spring as the COVID-19 pandemic took full force. The Centers for Disease Control and Prevention (CDC) estimated a 42 perce...
February 18, 2021 • Financial Support • HHS
Federal Financial Support for COVID-Related Losses are Still Available—Find Out More About Your Options!
As you well know, during the COVID-19 public health emergency (PHE), you, your emergency physician colleagues, and your group practices have not been immune from the economic consequences of reduced v...
September 3, 2020 • Financial Support
Advocating for Reforms to the COVID-19 Provider Relief Fund and Uninsured Program
Unfortunately, the U.S. Department of Health and Human Services (HHS) has continued to mishandle the distribution of the Provider Relief Fund (PRF), a $175 billion fund appropriated by Congress to hel...
April 30, 2020 • Financial Support
Don’t Blink! Changes to Financial Support Options Happening Non-stop!
I’ll be frank: I’m finding these blogs harder and harder to write as the COVID-19 pandemic continues. It seems that as soon as I write a blog, it becomes outdated.
April 23, 2020 • Financial Support
You Received Financial Relief. Should You Keep it?
For the last couple weeks, I have discussed issues related to the distribution of the $100 billion pot of funding that was included in the stimulus bill (the CARES Act). As I mentioned last week, you ...
April 16, 2020 • Financial Support
Health Care Providers Receive Financial Relief…with Strings Attached
Last Friday, you or your emergency medicine group should have received a payment that was automatically deposited in the bank account that you have on file with Medicare. This payment was part of an o...
April 9, 2020 • Financial Support
ACEP Pushes for More Financial Support for Emergency Physicians
As many of you know, the recently-passed federal COVID-19 stimulus bill (CARES Act) included a number of financial support options that could help you during this extremely difficult time. I would lik...
November 21, 2019 • Financial Support
Trump Administration Releases Far-Reaching Price Transparency Regs
If you didn’t know the Trump Administration was serious about promoting price transparency in health care, you do now! Last week, it issued two regs that will have major implications for hospitals, he...