Summary: Finalized Provider Financial Penalties for Information Blocking
What’s happening: A members-only summary, prepared by Health Policy Alternatives, Inc., of the finalized provider disincentives for information blocking is available.
What else to know: The rule is effective July 31.
CMS Proposal Seeks to Mitigate Abnormal DME Billing in Medicare Shared Services Program
What’s happening: The Centers for Medicare & Medicaid Services (CMS) released a proposed rule on abnormal billing activity within the Medicare Shared Savings Program.
What else to know: The proposed rule seeks to mitigate the impact of the billing activity on reconciliation of accountable care organization (ACO) payments in calendar year (CY) 2023.
CMS Proposes Reducing Medicare Payments to Physicians
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued its calendar year (CY) 2025 physician fee schedule (PFS) proposed rule.
What else to know: The proposed CY 2025 PFS conversion factor is $32.36, a decrease of $0.93, or 2.8%, from CY 2024.
CMS Proposes Inadequate Outpatient Payment Update
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2025 outpatient prospective payment system proposed rule.
What else to know: The rule includes a net market basket update of 2.6%. As a result of all proposed changes, CMS estimates that hospital outpatient payments will increase by $1.8 billion in CY 2025, excluding changes in enrollment, case mix, and utilization.
CMS Issues CY 2025 Physician Fee Schedule Proposed Rule
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued its calendar year (CY) 2025 proposed rule for the physician fee schedule (PFS).
What else to know: Comments on the proposed rule are due Sept. 9.
ONC Issues Additional Rule on Health Data, Technology, and Interoperability
What’s happening: The Office of the National Coordinator for Health Information Technology (ONC) issued a proposed rule to advance interoperability and improve information sharing among patients, providers, payers, and public health authorities.
What else to know: The proposed rule builds upon a final rule published in January.
DHCS Announces Upcoming Supplemental Payment Dates
What’s happening: The Department of Health Care Services (DHCS) has announced it will make disproportionate share hospital (DSH) payments on July 15.
What else to know: The payments will have a warrant date of July 11.
Letters to OHCA Board Highlight New Data, Caution Against Overly Broad Review Process
What’s happening: Last week, CHA submitted two letters to the Office of Health Care Affordability (OHCA) — one responding to the May OHCA board meeting, and another addressing the office’s proposed changes to the cost and market impact review (CMIR) regulations.
What else to know: The board met June 26 to approve the alternative payment model (APM) standards and discuss the proposed CMIR regulations, the draft workforce stability standards, and the draft primary care investment benchmark.
ONC Finalizes Financial Penalties for Information Blocking
What’s happening: The Office of the National Coordinator for Health Information Technology (ONC) issued a final rule on provider disincentives for information blocking.
What else to know: CHA is disappointed in the finalized policies and remains concerned about the selective application of penalties to certain health care providers, as previously outlined in comments.
CMS Proposes Inadequate Home Health Payment Update
What’s happening: The Centers for Medicare & Medicaid Services issued a proposed calendar year (CY) 2025 home health prospective payment system.
What else to know: CMS estimates payments to home health agencies, as a result of the changes in the proposed rule, will decrease by $280 million (1.7%). Other key provisions of the proposed rule include: