Programs

Regulatory Updates

Total of 187 Records Returned

State: Florida

CMS announced additional resources and flexibilities available in response to Hurricane Idalia in the State of Florida.

Date Posted : 08/31/2023

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

The Centers for Medicare & Medicaid Services announced today additional resources and flexibilities available in response to Hurricane Idalia in the State of Florida. CMS is working closely with the State of Florida to put these flexibilities in place to ensure those affected by this natural disaster have access to the care they need – when they need it most. On August 28, 2023, President Biden determined that an Emergency exists in the State of Florida due to the emergency conditions resulting from Hurricane Idalia beginning August 27, 2023, and continuing. Additionally, on August 30, 2023, Department of Health and Human Services Secretary Xavier Becerra determined that a Public Health Emergency exists in the State of Florida and has existed since August 27, 2023.

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State: All

Medicare Provider Enrollment changes

Date Posted : 08/17/2023

Program: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies, Home Infusion Therapy, Pharmacy, Sleep

Learn what’s changed, including information and resources for PECOS 2.0.

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State: Massachusetts

MA – Pharmacy allowed to process DME through POPS

Date Proposed : 01/5/2023

Date Effective : 07/7/2023

Program: Pharmacy

Durable medical equipment, oxygen/respiratory equipment
Provides the Executive Office and Health and Human Services (EOHHS) the authority to price durable medical equipment and medical supplies (DME) available through pharmacies with claims processed through the Pharmacy Online Processing System (POPS) at the lower of wholesale acquisition cost (WAC) and usual and customary charge (U and C).

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State: All

Period of enhanced oversight for new hospices in Arizonia, California, Neveda, and Texas.

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.

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State: Tennessee

Tennessee – changes to the Home Medical Equipment regulations

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.

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State: Florida

Referral of Patients By Health Care Providers

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 ;

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