Category: Current Affairs

New Whitepaper: Thriving under pressure: An efficiency blueprint for mid-sized systems

May 5, 2025

New Whitepaper: Thriving under pressure: An efficiency blueprint for mid-sized systems

Mid-sized health systems are under extraordinary pressure. Tight margins, limited buying power and fierce competition for talent leave little room for error – especially as labor shortages and rising costs escalate. But some are turning these constraints into opportunities.

Eighteen months ago, Mary Lanning Healthcare struggled to manage finances and allocate resources efficiently. Since then, the rural system has transformed its budget process, reduced administrative burdens on staff and uncovered new growth opportunities. Their approach offers replicable strategies for leaders navigating similar pressures.

Readers will learn:

  • Enhancing financial transparency with technology to drive smarter decisions,
  • Strategies to control costs and unlock growth opportunities, and
  • Simplify HR operations to boost staff satisfaction.

Click Here to Download this Whitepaper

CMS Proposes Revision to FY 2026 Medicare Inpatient Prospective Payment System – Comment by June 10

May 1, 2025

CMS Proposes Revision to FY 2026 Medicare Inpatient Prospective Payment System – Comment by June 10

This proposed rule would revise the Medicare hospital inpatient prospective payment systems (IPPS) for

  • operating and capital-related costs of acute care hospitals;
  • make changes relating to Medicare graduate medical education (GME) for teaching hospitals;
  • update the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs);
  • update and make changes to requirements for certain quality programs; and
  • make other policy-related changes.

To be assured consideration, comments must be received no later than 5 p.m. EDT on June 10, 2025.

In commenting, please refer to file code CMS-1833-P. Because of staff and resource limitations, comments cannot be accepted by facsimile transmission.

Comments, including mass comment submissions, must be submitted in one of the following ways:

  • Electronically – You may submit electronic comments on this regulation to: https://www.regulations.gov.
  • Regular Mail – You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1833-P, PO Box 8013, Baltimore, MD 21244-8013.
  • Be sure to allow sufficient time for mailed comments to be received before the close of the comment period.
  • Express or Overnight Mail – You may send written comments vi express or overnight mail to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1833-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850

Click Here to View CMS Fact Sheet on Proposed Rule

Click Here to Learn More

CMS Seeks Input to Streamline Medicare Regulations, Comment by June 10

April 29, 2025

CMS Seeks Input to Streamline Medicare Regulations, Comment by June 10

The Centers for Medicare & Medicaid Services (CMS) is issuing this Request for information (RFI) to solicit public feedback on potential changes to Medicare regulations with the goal of reducing the expenditures required to comply with Federal regulations.

Examples of questions they would like input on include:

  • Are there documentation or reporting requirements within the Medicare program that are overly complex or redundant?
  • How can Medicare better align its requirements with best practices and industry standards?
  • Are there existing regulatory requirements that could be waived, modified, or streamlined to reduce administrative burdens?

Healthcare providers, researchers, stakeholders, health and drug plans, and other members of the public should submit all comments in response to this RFI through the online submission form.

Comments must be submitted by 11:59 p.m. ET, June 10, 2025.

Responses to this RFI must be provided via on-line submission at the following website: https://www.cms.gov/files/document/unleashing-prosperity-through-deregulation-medicare-program-request-information.pdf

For assistance or technical problems related to this form, please send an email to: patientsoverpaperwork@cms.hhs.gov.

Click Here to Learn More about this RFI

Click Here to go to online submission form

CMS Innovation Center Ending Four Models Early

March 21, 2025

CMS Innovation Center Ending Four Models Early

Last week the Innovation Center at the Centers for Medicare & Medicaid Services (also known as CMMI) announced they are terminating four models early to align with its statutory obligation and strategic goals.

Innovation Center Models are intended to be time-limited experiments to determine what approaches should be:

  • expanded nationwide,
  • what components need further testing, and
  • what approaches are not viable for expansion.

The models are ending early are:

Termination of the ETC model will be proposed through rulemaking. Subject to discussions with State authorities, Maryland will transition to the AHEAD model and begin its implementation period in January 2026.

Click Here to Learn More

CMS Rescinds Medicaid Guidance on Health-Related Social Needs

March 13, 2025

CMS Rescinds Medicaid Guidance on Health-Related Social Needs

Last week, the Centers for Medicare & Medicaid Services (CMS) announced rescission of previous guidance for Center Information Bulletins (CIBs) related to services and supports addressing health-related social needs (HRSN) for Medicaid and state Children Health Insurance Programs (CHIPs). The rescinded guidance includes:

Rescinding this guidance does not negate programs that are currently approved. Rather, it informs States and the public that CMS will review applications to cover HRSN services on a case-by-case basis.

Click Here to Read More

 

Where the Physician Shortage is Headed – and What it Means

March 7, 2025

Where the Physician Shortage is Headed – and What it Means

According to a recent report, the shortfall of physicians could reach as high as 86,000 by the year 2036. NRHA COO Brock Slabach says rural areas are already affected by workforce shortages, with primary care in especially high demand. Subspecialties already experiencing a shortage are bracing for impact as demand for eye care and other categories exacerbate shortfalls.

Act soon to share your perspective in Stroudwater’s physician compensation survey.

Click Here to access the survey

Article: The Other Physician Pipeline Problem

March 4, 2025

Article: The Other Physician Pipeline Problem

The Association of American Medical Colleges reported in 2021 that physicians aged 65 and older accounted for 20% of the active patient care workforce, and those between 55 and 64 years old made up 22%. In 2023, physicians 65 and older were 23.4% of the active clinical workforce.

These data show that more than a third of currently active physicians will reach retirement age within the next decade – if they have not already.

This spells a problem not only for patients but also hospitals, many of which are already operating within tight margins. Failing to replace a vacant physician role can heavily cost an organization.

Click Here to Read Full Article

DEA & HHS Delay Implementation of Final Rules

February 25, 2025

DEA & HHS Delay Implementation of Final Rules

The Drug Enforcement Administration (DEA) and the Department of Health and Human Services (HHS) have announced a delay in the effective date for the recently issue final rules regarding the telemedicine prescribing of buprenorphine and telemedicine for Veterans Affairs Patients. Originally scheduled to become effective February 18, the rules will now take effect on March 21, 2025.

This decision aligns with the White House memorandum issued on January 20, which called for “A Regulatory Freeze Pending Review” to allow agencies further review of any fact, law, and policy considerations prior to proposing, issuing, or finalizing any regulatory activities. In particular, the DEA/HHS announcement cites the third paragraph of the Freeze Memo, which ordered agencies to consider postponing the effective dates for any recently published rules that have yet to take effect.

The DEA and HHS have also confirmed that the waiver provisions established in the third extension of telemedicine flexibilities for prescribing controlled substances will remain in effect through December 31, 2025, ensuring that in-person visit requirements continue to be waived for the remainder of 2025.

Click Here to Read More

Click Here to Read Buprenorphine Rule

Click Here to Read Veterans Affair Rule

Click Here to Read Telemedicine Special Registration Rule

CMS Provides Billing Instructions for Opioid Treatment Programs (OTP) Telecommunications Add-On Codes

February 18, 2025

CMS Provides Billing Instructions for Opioid Treatment Programs (OTP) Telecommunications Add-On Codes

In the 2025 Final Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) finalized important updates for Opioid Treatment Programs (OTPs) aligning with regulations previously adopted by the Substance Abuse and Mental Health Services Administration (SAMHSA). These changes aim to enhance access to care for individuals with opioid use disorder (OUD) by expanding telehealth options.

Key Updates include:

  • Periodic assessments may now be conducted via audio-only technology on a permanent basis if live video is unavailable, as long as they meet all applicable SAMHSA and DEA requirements.
  • The OTPs intake add-on code (G2076) can now be billed when using live video for the initiation of methadone treatment.

As a result of these changes, CMS has updated its Opioid Treatment Program (OTP) webpage to reflect proper billing practices. OTPs should use the following HCPCS add-on codes when treating eligible patients:

  • G2076 – Used to initiate buprenorphine or methadone treatment via two-way interactive audio-video or audio-only technology when video is unavailable.
  • G2077 – covers periodic patient assessments via audio-only technology when video is unavailable.
  • G2080 – Applies to additional counseling or therapy provided via audio-only technology when video is unavailable.

For more details on the finalized policy, review the 2025 Final Physician Fee Schedule.

To learn more about billing and G-codes for OTPs, visit the CMS Opioid Treatment Program webpage.

Click Here to go to 2025 Final Physician Fee Schedule

Click Here to go to CMS Opioid Treatment Program webpage.

HHS Proposes Major Updates to HIPAA Security Rule to Strengthen Cybersecurity, Comments due March 7

February 18, 2025

HHS Proposes Major Updates to HIPAA Security Rule to Strengthen Cybersecurity, Comments due March 7

For the first time in two decades, the Department of Health and Human Services (HHS) has proposed significant updates to the HIPAA Security Rule to better protect electronic protected health information (ePHI) from increasing cyber threats. The Notice of Proposed Rulemaking (Proposed Rule) seeks to modernize security safeguards in response to a significant increase in large-scale healthcare breaches caused by hackers and ransomware between 2018 and 2023.

If enacted, the rule would require all HIPAA-regulated entities to:

  • Enhance cybersecurity practices, including maintaining an up-to-date inventory of technology assets,
  • Conducting annual risk analyses,
  • Implementing stronger patch management policies, and
  • Using multi-factor authentication.

Additionally, covered entities would be obligated to:

  • Encrypt ePHI,
  • Perform vulnerability scans and penetration testing, and
  • Ensure more rigorous oversight of business associates handling sensitive health data.

As remote care platforms manage vast amounts of ePHI, these new cybersecurity rules could significantly impact telehealth services.

The Proposed Rule also emphasizes stricter compliance documentation and monitoring, including mandating a 72-hour disaster recovery plan, annual compliance audits, and stronger incident response protocols. Notably, business associates would be required to notify covered entities of any contingency plan activation within 24 hours.

The proposed rule also seeks comments on emerging technologies such as artificial intelligence, quantum computing, virtual and augmented reality, and HIPAA’s role in regulating these emerging technologies.

Comments are due by March 7, 2025 and can be submitted through the federal register.

Click Here to Read More