On July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) released its proposed Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2023. Arguably the most noteworthy provision in the proposed rule is the agency’s suggested cut to physician payments. However, the rule also includes a number of other policy proposals, including changes to Medicare accountable care organizations (ACOs), behavioral health care, cancer screening, and dental care. (Read more...)

On July 15, 2022, CMS released the proposed rule for the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Centers (ASCs) for CY 2023. The agency proposes an increase in payments to outpatient providers and offers insight on the new rural emergency hospital program, as well as to how it might respond to the recent U.S. Supreme Court decision on the 340B Program. (Read more...)

On July 20, 2022, the Office of Inspector General (OIG) of the U.S. Department of Health & Human Services (HHS) released a Special Fraud Alert on telemedicine. On the same day, the U.S. Department of Justice (DOJ) announced a “nationwide coordinated law enforcement action” against 36 defendants, and the Centers for Medicare & Medicaid Services (CMS) Center for Program Integrity announced administrative actions against 52 providers, related to alleged telemedicine arrangements. These coordinated actions indicate a growing scrutiny of telemedicine arrangements by federal government regulators. (Read more...) 

RTM, formally called Remote Therapeutic Monitoring / Treatment Management, “encompasses the collection and monitoring of therapy adherence and therapy response data along with treatment management services.” The RTM concept was created in October 2020 by the Current Procedural Terminology (CPT) Editorial Panel. RTM consists of five general medicine CPT codes, which were created in order to fill in some of the “noteworthy gaps that exist in the current coverage and delivery of [remote patient monitoring]….[and] help patients experience more consistency and quality along the continuum of care, especially in the realm of chronic disease monitoring.” (Read more...) 
"Healthcare Compensation Plans: Current Challenges and Novel Approaches" authored by HCC President, Todd A. Zigrang, MBA, MHA, FACHE, CVA, ASA, was published by the American College of Healthcare Executives in the Summer 2022 issue of Frontiers of Health Services Management.

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On August 18, 2022, HCC President, Todd A. Zigrang, MBA, MHA, FACHE, CVA, ASA, and, HCC Senior Vice President and General Counsel, Jessica Bailey-Wheaton, Esq., will present on the topic of "Healthcare Regulatory Updates & Valuation Implications," during the National Association of Certified Valuators and Analysts (NACVA) 2022 Business Valuation and Financial Litigation Super Conference.