About Laws & Regulations
Navigating the vast network of health care laws and regulations is difficult. To help hospitals, CHA produces manuals and guidebooks, including the Consent Manual, a one-stop resource for all legal requirements related to patient consent for medical treatment, release of medical information, reporting requirements and more; the Model Medical Staff Bylaws and Rules, which outline the framework for working relationships among medical staff, hospital administrators and governing bodies; and the California Hospital Compliance Manual, which covers high-risk compliance issues. CHA also represents California hospitals’ interests in court on issues, including reimbursement, labor and employment, and more.
Proposed Rule Would Increase Medicare Advantage Plan Oversight
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for contract year 2026 that would increase oversight of Medicare Advantage (MA) plans.
What else to know: The rule includes additional proposed changes to the prior authorization process and guardrails for artificial intelligence use.
CHA FAQs Detail AB 2975 Hospital Weapon Detection Requirements
What’s happening: Following numerous questions about Assembly Bill (AB) 2975’s requirements, CHA has developed a frequently-asked-questions (FAQs) fact sheet to assist hospitals with planning for implementation.
What else to know: AB 2975 will require all hospitals to adopt and implement a weapon detection policy — and screen at certain entrances for instruments capable of causing death or serious bodily injury — by sometime around March 2027.
CHA Supports Eliminating Low Wage Index Hospital Policy for FFY 2025
What’s happening: CHA submitted comments in support of an interim final rule that eliminates the low wage index policy and associated budget neutrality adjustment for federal fiscal year (FFY) 2025.
What else to know: The rule was issued by the Centers for Medicare & Medicaid Services (CMS) in response to the U.S. Court of Appeals for the District of Columbia Circuit (D.C. Circuit) decision in Bridgeport Hospital, et al., v. Becerra.
DEA, HHS Extend Telehealth Prescribing Flexibilities
What’s happening: The U.S. Drug Enforcement Administration (DEA) and federal Department of Health and Human Services (HHS) extended existing waiver flexibilities for prescribing controlled substances via telemedicine through Dec. 31, 2025.
What else to know: This is the third extension.
2025 ESRD PPS Final Rule Members-Only Summary Available Now
What’s happening: A members-only summary of the Centers for Medicare & Medicaid Services’ calendar year (CY) 2025 end-stage renal disease (ESRD) prospective payment system (PPS) final rule, prepared by Health Policy Alternatives, Inc., is available.
What else to know: The regulation is effective Jan. 1, 2025.
Members-Only Summary on CMS 2025 Home Health PPS Final Rule Now Available
What’s happening: A summary of the Centers for Medicare & Medicaid Services’ calendar year (CY) 2025 home health (HH) prospective payment system (PPS) final rule, prepared by Health Policy Alternatives, Inc., is available solely to CHA members.
What else to know: The regulation is effective Jan. 1, 2025.
CMS Reduces Medicare Payments to Physicians in Final Rule
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued its calendar year (CY) 2025 Medicare physician fee schedule (PFS) final rule, in which the final CY 2025 PFS conversion factor is $32.35 — a decrease of 2.8% from CY 2024.
What else to know: CMS published a fact sheet on the CY 2025 Medicare PFS that shares the rate setting and conversion factor, and much more.
CMS Finalizes Medicare Payments for Home Health, Dialysis Services
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued final rules for the calendar year 2025 home health prospective payment system (PPS) and end-stage renal disease PPS.
What else to know: CMS estimates a 0.5% increase in payments for home health agencies and dialysis providers treating end-stage renal disease (ESRD) patients will see an increase of 2.7%.
CMS Finalizes Inadequate Outpatient Payment Update, Establishes New Conditions of Participation
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued its calendar year (CY) 2025 outpatient prospective payment system (OPPS) final rule, including a net market basket update of 2.9%.
What else to know: CMS also establishes new health and safety standards for obstetrical services to be phased in over two years.
2024 Legislative Wrap-up
Don’t miss CHA’s upcoming webinar — your essential guide to navigating new health care laws and regulations. This interactive session is designed to give you a clear, actionable understanding of the latest legislative updates that could impact your operations. Our expert panel will cover key 2024 legislation, highlight crucial deadlines, and answer your pressing questions, ensuring you’re well-prepared for the challenges and opportunities ahead.