Latest news

January 15, 2021

CMS finalizes rule to streamline prior authorizations

Katie Adams | January 15, 2021 CMS finalized a rule Jan. 15 to simplify prior authorizations and create a better exchange of healthcare data between payers, providers and patients. The rule requires payers in Medicaid, Children’s Health Insurance Program and Qualified Health Plan to build application programming interfaces to ease data exchange and prior authorizations….

January 08, 2021

HHS expands COVID-19 public health emergency until April, preserving key telehealth flexibilities

Robert King | Jan 8, 2021  The Department of Health and Human Services (HHS) has extended the public health emergency surrounding the COVID-19 pandemic until April, extending key waivers for regulations on a variety of topics such as telehealth. The public health emergency declaration was originally scheduled to expire Jan. 21. HHS Secretary Alex Azar extended the…

December 22, 2020

CMS finalizes rule to ease value-based arrangements for prescription drugs

Rebecca Pifer | December 22, 2020 The Trump administration on Monday finalized a rule meant to make it easier for state Medicaid programs, commercial insurers and drug manufacturers to enter into value-based arrangements tying prescription drug payments to clinical outcomes. The rule overhauls existing regulations that stymied value-based payments, CMS said, in a bid to…

December 21, 2020

Provider-friendly surprise billing fix, more funds for hospitals in year-end spending bill

Rebecca Pifer | December 21, 2020 Dive Brief:Year-end legislation bipartisan leaders finalized late Sunday includes a long-awaited ban on surprise medical bills, along with $900 billion in new COVID-19 relief, according to top Democrats House Speaker Nancy Pelosi and Senate Minority Leader Chuck Schumer. The sweeping package comes less than a week after leaders of…

December 02, 2020

CMS makes some telehealth coverage permanent, finalizes specialty rate cuts

December 2, 2020 Broadly, the changes benefit general medicine at the expense of specialty providers. Medical groups spoke out against the cuts to pay of many specialties in the physician fee schedule released late Tuesday, arguing they could be disastrous for providers if 2021 sees a continuation of the rising expenses and declining revenue that’s…