Regs & Eggs
- On July 26, CMS released its Maternity Care Action Plan to support the implementation of the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis. The goal of the action plan is to create a wholistic approach across CMS to improve health outcomes and reduce inequities for people during pregnancy, childbirth, and the postpartum period.
- On July 11, CMS issued additional EMTALA guidance, following up on the previous guidance from September 2021. In this updated guidance, CMS reiterates that EMTALA pre-empts any directly contradicting state laws around the medical screening examination, stabilizing treatment, and transfer requirements. In addition to the guidance, HHS Secretary Xavier Becerra, in a letter to clinicians and facilities, further made clear that this federal law preempts state law restricting access to abortion in emergency situations. ACEP has created a new resource page to help emergency physicians stay updated on emergency care in the post-Roe era.
- On July 15, CMS issued the calendar year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed regulation. Among other policies, the reg proposes a new payment structure and quality reporting program for Rural Emergency Hospitals (REH) and provides for payment for certain behavioral health services furnished via communications technology. This is the second reg that includes policies related to REHs. CMS released another proposed reg at the end of June that includes proposed conditions of participation for this new facility type.
- The Medicare Payment Advisory Commission (MedPAC) has released its 2022 data book on health care spending and the Medicare program, with data on Medicare spending, Medicare population demographics, beneficiary access to care, quality of care, specific provider settings, provider profit margins, and the Medicare Advantage and Medicare Part D programs. MedPAC also highlighted research on the impact of health care consolidation on health care prices.
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 27, 2022 • CMS Info • No Surprises Act • ED Management
Recent Federal Efforts to Address Provider Consolidation
There has been a significant amount of interest over the last couple of years from the federal government to examine the growth in “provider consolidation” and assess the impact this trend has had on ...
January 20, 2022 • No Surprises Act
ACEP Launches Website Highlighting Major No Surprises Act Requirements for Emergency Physicians
As you all know, the important consumer protections instituted by the No Surprises Act went into effect on January 1. I have written numerous blog posts about the major policy issues that have resulte...
January 13, 2022
The No Surprises Act
A summary of the major requirements and what they mean for you.
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 18, 2021 • CMS Info • HHS • No Surprises Act
Status Update: ACEP Actions to Push Back Against Flawed No Surprises Act Regulation
As you may recall, I went into depth in a Regs & Eggs blog in early October breaking down the significantly flawed second interim final regulation implementing the No Surprises Act. Now, a month and a...
November 11, 2021 • CMS Info • ED Management • Medicare Info
Breaking Down the Biden Administration’s New Vaccine Mandates: How Do they Impact you?
As I’m sure you’ve heard by now, last week, the Biden Administration released two new regulations regarding mandatory COVID-19 vaccinations. First, the Centers for Medicare & Medicaid Services (CMS) i...
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...
October 7, 2021 • Advocacy Info • HHS • No Surprises Act
Breaking Down the Concerning and Flawed Second Interim Final Reg Implementing the No Surprises Act
As many of you already know, last week, the Departments of Health and Human Services (HHS), Treasury, and Labor (the Departments) and the Office of Personnel Management (OPM) issued an interim final r...
September 30, 2021 • Advocacy Info • ED Management • EHR Info • HHS
The Office of the National Coordinator Provides Important Clarifications on Data Sharing Requirements
A couple weeks ago, the Office of the National Coordinator (ONC) for Health Information Technology within the U.S. Department of Health and Human Services (HHS) hosted a webinar that provided importan...
September 23, 2021 • Advocacy Info • Alternative Payment Model • CMS Info • Medicare Info • Telehealth
ACEP Responds to Request for Information on Rural Emergency Hospitals
Last Friday, ACEP formally responded to a major regulation issued by the Centers for Medicare & Medicaid Services (CMS) impacting Medicare outpatient hospital payments in 2022. As you may recall, the ...
September 15, 2021 • Advocacy Info • CMS Info • Medicare Info • MIPS Info • Physician Fee Schedule • Telehealth
ACEP Responds to Major Medicare Regulation Impacting Physician Payments
On Monday, ACEP submitted a comprehensive response to the Centers for Medicare & Medicaid Services’ (CMS’) Calendar Year (CY) 2022 Physician Fee Schedule (PFS) and Quality Payment Program (QPP) propos...
September 9, 2021 • Advocacy Info • CMS Info • HHS • Medicare Info • Physician Fee Schedule
Medicare Trustees Release Annual Report: What’s In it and How it Impacts You
Every year, the Medicare “Trustees” issue a comprehensive report outlining the financial outlook for the Medicare program in both the short-term and the long-term (i.e., the next 75 years!). Before br...
September 2, 2021 • Advocacy Info • HHS • No Surprises Act
ACEP and EDPMA Officially Respond to the First 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 an interim final regulation implementing part of the No Surprises Act. If...
August 26, 2021 • Advocacy Info • CMS Info • ED Management
Emergency Department “Boarding” At Seemingly All-Time High Levels
As many of you as emergency physicians undoubtedly know (and have experienced), crowding in the emergency department (ED) has been an issue for years—in some cases causing ED “boarding,” which can kee...
August 19, 2021 • Advocacy Info • CMS Info • Medicare Info • Alternative Payment Model
CMS Outlines its Vision for Innovation: How Does Emergency Medicine Fit in?
After a three-week summer vacation, Regs & Eggs is back in full swing! There is much to catch you all up on in the regulatory world, so grab your eggs and let’s dig right into some of the recent news....
July 22, 2021 • Advocacy Info • CMS Info • Medicare Info
CMS Releases 2022 Medicare Outpatient Hospital Payments: Requests Comment on Rural Emergency Hospitals
It’s definitely reg season (health policy folks’ favorite time of the year)! Earlier this week, the Centers for Medicare & Medicaid Services (CMS) issued a proposed regulation impacting Medicare outpa...