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.
January 16, 2020 • Advocacy Info
Advocating for Emergency Telehealth Reimbursement
Innovations around telehealth are a critical way to give patients greater access to an emergency physician in an inner-city or rural emergency department (ED). Telehealth access from the ED setting to...
January 9, 2020 • MIPS Info
MIPS Updates for the New Year
Although I recently wrote about the upcoming policy changes to the Merit-based Incentive Payment System (MIPS), the major quality reporting program for physicians under Medicare, the Centers for Medic...
January 2, 2020
Reflections on 2019: A year full of regulatory victories
Happy New Year! 2019 has come to a close, and it's time to reflect on an exciting and productive year in the regulatory world. Here are ACEP’s top 10 advocacy achievements of the past year (in no part...
December 19, 2019 • Opioids Info
New Guidelines Coming for Prescribing Opioids to Treat Acute Pain
The Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids to treat chronic pain has become a hot topic as the nation continues combating the opioid epidemic.
December 12, 2019 • MIPS Info
MIPS: Upcoming Changes You Should Know About
Many of you are all too familiar with the Merit-based Incentive Payment System (MIPS), the major quality reporting program for physicians under Medicare. MIPS measures performance in four categories —...
December 5, 2019 • Alternative Payment Model
Two PTAC Members Resign: What does this mean for the AUCM?
The week before Thanksgiving there were rumblings in DC, and it wasn’t just people’s hungry stomachs. Right before the holiday, two members of the Physician-Focused Payment Model Technical Advisory Co...
November 28, 2019
Giving Thanks for Beneficial Regs and Our Holiday Wish List
Happy Thanksgiving everyone! This week, please enjoy some regs with turkey legs!
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...
November 14, 2019 • FDA Info
FDA Drug Shortage Task Force Releases Long-Awaited Report: Highlights and Next Steps
The ongoing shortage of life-saving medicines is one of the biggest challenges emergency physicians face on a daily basis. Fortunately, progress is finally being made to address this critical issue.
November 7, 2019 • CMS Info
CMS Releases Major Final Reg: 2020 Medicare Physician Fee Schedule
Last Friday, the Centers for Medicare & Medicaid Services (CMS), released its final 2020 Medicare Physician Fee Schedule (PFS) reg, which includes changes that will affect Medicare physician payments ...
October 24, 2019
Reforming the Stark Law
You may have heard of the long-standing Medicare “Stark Law” which prohibits a physician from self-referring (i.e. making referrals for services if the physician or an immediate family member has a fi...
October 17, 2019 • Opioids Info
The Balancing Act: Addressing the Opioid Crisis vs. Exacerbating Drug Shortages
As I mentioned previously, the Trump Administration has taken numerous actions to address the opioid crisis.
October 10, 2019 • Medicare Info
President Trump’s Response to “Medicare-for-All”
As you may have seen, there has been a growing movement among the public and lawmakers to push for Medicare-for-All, which would dramatically expand the current Medicare program to provide a public he...
October 3, 2019 • HHS
This Just In: The HHS Secretary Thinks AUCM is Awesome!
The long wait is over! After a year, the Secretary of the U.S. Department of Health and Human Services (HHS) responded to the PTAC’s recommendation on ACEP’s Medicare alternative payment model (APM), ...
September 26, 2019 • Physician Fee Schedule
ACEP Responds to a Major Proposed Reg: 2020 Medicare Physician Fee Schedule
Earlier this week, ACEP submitted a letter to the Centers for Medicare & Medicaid Services (CMS), responding to their proposed 2020 Medicare Physician Fee Schedule—which was released in July. This is ...
September 19, 2019
Trump Administration Changes to “Public Charge” Policies Could Negatively Impact Your Patients
Last month, the Department of Homeland Security (DHS) finalized changes to an existing reg that allows the federal agency to consider whether an immigrant would likely at any time become a “public cha...
September 12, 2019
Wading through SAMHSA’s Long-Awaited 42 CFR Part 2 Reg
If you’re a true “Reg Head,” like me, you were eagerly awaiting the U.S. Department on Health and Human Services (HHS) to release the Substance Abuse and Mental Health Services Administration (SAMHSA)...
September 5, 2019 • Opioids Info
Reducing Barriers to Treatment for Patients with Opioid Use Disorder
As an emergency physician, you have undoubtedly seen first-hand the devastating effects that the opioid crisis has had on our communities.
August 29, 2019
The Appropriate Use Criteria Program is Starting in 2020: Learn More and Take Action on Exemption for Emergencies
You may have heard about the upcoming Medicare requirement to consult Appropriate Use Criteria (AUC) through approved clinical decision support mechanisms prior to ordering advanced imaging services.
August 22, 2019
Diving into the Regs: Proposed Price Transparency Requirements for Hospitals
In my last blog, I discussed the major highlights of the Calendar Year (CY) 2020 Medicare Physician Fee Schedule (PFS) and Quality Payment Program (QPP) Proposed Rule from the Centers for Medicare & M...
August 15, 2019 • Physician Fee Schedule
Diving into the Regs: Highlights of the 2020 Medicare Physician Fee Schedule
As discussed in my last blog, the Centers for Medicare & Medicaid Services (CMS) recently released major regs that impact emergency medicine.
August 8, 2019
Reg Season is in Full Swing!
Reg Season has officially begun! Last week, the Centers for Medicare & Medicaid Services (CMS) issued numerous proposed and final regs that impact emergency medicine. I will be working with ACEP staff...
July 29, 2019 • Medicare Info
BREAKING NEWS: Major Medicare Payment Rule Adjusts Value of Emergency Medicine Services
The Centers for Medicare & Medicaid Services (CMS), the agency responsible for running Medicare and Medicaid, just issued their proposed Medicare physician fee schedule for 2020.
July 25, 2019 • Alternative Payment Model
The Awesome AUCM Model
I know what you may be thinking…where are the Medicare regs? It’s supposed to be reg season, but there seems to be a major reg drought! Don’t worry, the regs are coming.
July 18, 2019 • MIPS Info
2018 MIPS Results are in! How did you do?
The Centers for Medicare & Medicaid Services (CMS) recently released the 2018 results for the Merit-based Incentive Payment System (MIPS)—the major quality reporting program for physicians under Medic...