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.
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.
CMS Delays Start Date for Proposed Payment Model to Expand Kidney Transplant Access
What’s happening: The Centers for Medicare & Medicaid Services (CMS) anticipates it will delay the proposed Increasing Organ Transplant Access (IOTA) Model start date until after Jan. 1, 2025.
What else to know: CMS anticipates a start date delay because it is still working to finalize the rule; the agency has not yet shared a new start date.
CHA Releases Report to Help Hospitals Comply with New Laws
What’s happening: Hospitals can use the 2024 Report on State Legislation as they navigate the many health care-related bills the governor signed into law this session.
What else to know: The report summarizes the most significant health care bills of the year, as well as broader legislative changes that affect patients and employers.
CHA 2025 Legal Update Webinar Tackles Workplace Compliance in Health Care
What’s happening: CHA is hosting a members-only webinar on Nov. 13 from 10-11 a.m. (PT) to discuss recently enacted labor and employment laws that will impact hospital workplace operations in 2025.
What else to know: Erika Frank, vice president, legal counsel, is co-hosting this webinar with Gail Blanchard-Saiger, principal with Blanchard Saiger Law. Registration is open.
CMS Finalizes Medicare Observation Appeals Processes
What’s happening: The Centers for Medicare & Medicaid Services (CMS) has established appeals processes for Medicare beneficiaries who were admitted as inpatient but whose status changed to outpatient observation during their hospital stay.
What else to know: The appeals processes only apply to patients enrolled in traditional Medicare, not patients enrolled in Medicare Advantage.