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This Week in Policy and Medicine January 5, 2025
Welcome to another edition of our weekly roundup, where we dive into the most pressing legal, regulatory, and policy updates that…
MA Star Ratings Decrease, Insurers Sue
Under recent data released by the Centers for Medicare and Medicaid Services (CMS), roughly 405 of Medicare Advantage (MA) plans…
CMS Readies for Round Two of Drug Price Negotiations
Recently, the Centers for Medicare and Medicaid Services (CMS) issued guidance on the second round of the drug price negotiation…
CMS 2025 Physician Fee Schedule Includes 2.9 Percent Pay Cuts for…
The Centers for Medicare & Medicaid Services (CMS) has released the calendar year (CY) 2025 Revisions to Payment Policies…
Senate Releases Report Alleging MA Insurers Deny Patient Care to Increase…
The United States Senate Permanent Subcommittee on Investigations recently released a report focused on Medicare Advantage…
CMS Finalizes TEAM through IPPS Final Rule
On August 28, as part of its Fiscal Year 2025 Hospital Inpatient Prospective Payment System (IPPS) Final Rule, the Centers for…
CMS Proposes Changes to Reporting and Returning Medicare Parts A and B…
Tucked into the Physician Fee Schedule is a provision that should be of interest to False Claims Act attorneys. Regarding Medicare…
CMS Releases Prices for Inflation Reduction Act Drug Price Negotiation…
On Thursday, August 15, 2024, the Centers for Medicare & Medicaid Services (CMS) released the prices for the first 10…
Humana Reaches $90 Million Settlement in First of Its Kind False Claims Act…
Humana recently reached a $90 million settlement with the United States to resolve allegations that Humana submitted fraudulent…
HHS Endorses Telehealth Accreditation Programs
In September of 2024, the U.S. Department of Health and Human Services (HHS) published its stamp of approval for telehealth…