Regulatory Updates

State: All

Date Posted : 07/13/2023

Date Effective : 07/13/2023

Program: Hospice

CMS is placing newly enrolling hospices located in Arizona, California, Nevada, and Texas in a provisional period of enhanced oversight. Over the last 12 months, we’ve received numerous reports of hospice fraud, waste, and abuse. The number of enrolled hospices has also increased significantly in these states, raising serious concerns about market oversaturation.

State: Tennessee

Date Proposed : 06/26/2023

Date Effective : 06/26/2023

Date Adopted : 06/26/2023

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

Public Chapter 0099 of the 113^th General Assembly, cited as "Quinniee's Law," requires immediate changes to the rules regarding home medical equipment services Quinniee's Law removes the requirement that a Home Care Organization providing Home Medical Equipment have a physical location in Tennessee. The removal of a physical requirement will allow additional access to care by allowing out-of-state providers without a physical location in Tennessee to obtain licensure in Tennessee.

State: Florida

Date Proposed : 03/7/2023

Date Effective : 07/1/2023

Date Adopted : 06/16/2023

Program: Sleep

Relates to referral of patients by health care providers; deletes the definitions of the terms direct supervision and present in the office suite; revises the definition of the term referral to remove reference to direct physician supervision and to require compliance with certain Medicare payment and coverage rules. 3. The following orders, recommendations, or plans of care shall not constitute a referral by a health care provider: f. By a health care provider who is the sole provider or member of a group practice for designated health services or other health care items or services that are prescribed or provided solely for such referring health care provider's or group practice's own patients, and that are provided or performed by or under the supervision of such referring health care provider or group practice if such supervision complies with all applicable Medicare payment and coverage rules for services ;

State: Georgia

Date Proposed : 09/6/2022

Date Effective : 06/9/2023

Date Adopted : 05/20/2023

Program: Pharmacy

Removed references to pharmacy benefits managers, which are no longer licensed by the Georgia Board of Pharmacy. Eliminated the provision that caused a pharmacy's change in location to void its license, as the Board determined that there is no basis to void a license solely because a pharmacy has changed locations, and it imposes substantial cost and inconvenience on licensees without significant regulatory benefit. Clarified how changes in ownership and changes in location should be accomplished.

State: All

Date Posted : 06/15/2023

Date Effective : 07/1/2023

Program: Acute Care Hospital

Hospital outpatient prospective payment system: updated July 2023

State: All

Date Posted : 06/15/2023

Date Effective : 07/1/2023

Program: Ambulatory Surgical Centers (ASC)

Ambulatory Surgical Center Payment System updated July 2023