Programs

Regulatory Updates

Total of 186 Records Returned

State: Texas

Texas – CMS announces available waivers to Texas Providers affected by Hurricane Beryl

Date Posted : 07/15/2024

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Clinical Laboratory, Critical Care Hospital, Durable Medical Equipment, Prosthetics, Orthotics, and Supplies, Home Health, Hospice, Renal Dialysis

Effective on July 15, 2024, and retroactive to July 5, 2024, the Centers for Medicare & Medicaid Services (CMS) announces resources and flexibilities available in response to Hurricane Beryl in Texas. Below is a list of the waivers. Visit the CMS Hurricanes & Tropical Storms webpage or the Section 1135 Waiver webpage for updates.

  • Certain conditions of participation, certification requirements, program participation or similar requirements for individual health care providers or types of health care providers, including as applicable:
    • Hospital or other provider of services.
    • Physician or other health care practitioner or professional.
    • Health care facility.
    • Supplier of health care items or services.
  • Requirements that physicians or other health care professionals hold licenses in the State in which they provide services, if they have an equivalent license from another State (and are not affirmatively barred from practice in that state, or any state, a part of which is included in the emergency area).
  • Sanctions under section 1877(g) of the Act (physician self-referral law, relating to limitations on physician referral) under such conditions and in such circumstances as the CMS determines appropriate.
  • Waived sanctions and penalties arising from noncompliance with the following provisions of the HIPAA privacy regulations:
  • The requirements to obtain a patient’s agreement to speak with family members or friends or to honor a patient’s request to opt out of the facility directory (as set forth in 45 C.F.R. § 164.510).
  • The requirement to distribute a notice of privacy practices (as set forth in 45 C.F.R. § 164.520).
  • Pursuant to Section 1135(b)(5) of the Act, modified deadlines and timetables and for the performance of required activities, but only to the extent necessary, as determined by the CMS, to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the Medicare, Medicaid and CHIP programs and to ensure that health care providers that furnish such items and services in good faith, but are unable to comply with one or more of these requirements as a result of Hurricane Beryl, may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination of fraud or abuse.
Health care providers who need additional flexibilities, which are not listed above and specific to the effects resulting from Hurricane Beryl, can submit a request to CMS here.

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State: Michigan

Michigan – Provide access to quality Complex Rehabilitation Technology

Date Proposed : 06/28/2023

Date Effective : 07/23/2024

Program: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies

The department shall establish focused policies and promulgate focused rules for complex rehabilitation technology products and services. The focused policies and rules must take into consideration the individually configured nature of complex rehabilitation technology and the broad range of services necessary to meet the unique medical and functional needs of an individual with complex medical needs.

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State: Illinois

Illinois – Pharmacy Practice Act

Date Effective : 01/1/2026

Program: Pharmacy

This rulemaking would update several sections of these rules, including the creation of a new section regarding Approved Certified Pharmacy Technicians Programs. New Rule as of January 1, 2026 - the pharmacist in charge of a nonresidential pharmacy will need to be licensed by the state of Illinois.

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State: All

CMS 2025 Proposed Rule for Hospitals and Ambulatory Surgical Centers

Date Posted : 07/19/2024

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Critical Care Hospital

This proposed rule would revise the Medicare hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2025 based on our continuing experience with these systems.

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State: All

CMS Request for electronic funds transfer (EFT) form for DMEPOS providers
Program: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies, Pharmacy

All DME Suppliers Should Act Immediately All DME suppliers - even those that didn’t receive one of the April 25 letters - should ensure that none of their locations receive paper checks from Medicare hasta pronto! For any locations that do, suppliers should:

  1. Submit Form CMS-588 and a copy of a voided check to the applicable enrollment contractor before July 24, 2024. Be sure an authorized or delegated official from PECOS signs the enrollment document.
  2. Attach a copy of the April 25 letter for easier enrollment processing. If the letter is not available, we recommend suppliers prepare an attachment listing NPIs and PTANs.
Depending on the supplier location, CMS-588 submission instructions are available at:
  1. NPE East – https://www.novitas-solutions.com/webcenter/portal/DMEPOS/pagebyid?contentId=00291192
  2. NPE West - https://www.palmettogba.com/palmetto/npewest.nsf/DID/CHEQ2K5614

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State: Maryland

Maryland Department of Health Issues Six-Month Pause on New Enrollments of Select Provider Types to Address Potential Fraud, Waste, and Abuse

Date Effective : 07/1/2024

Program: Behavioral Health

Effective July 1, 2024, the Maryland Department of Health is imposing a six-month pause on new enrollments into the Maryland Medicaid Program of the following behavioral health program types, which are licensed under Maryland Code of Maryland Regulations 10.63 and 10.09:

  1. Psychiatric Rehabilitation Programs
  2. Psychiatric Rehabilitation Programs, Health Home
  3. Level 2.5 Partial Hospital Programs, and
  4. Level 2.1 Intensive Outpatient Treatment Programs

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