Regulatory Updates

State: All

Date Posted : 11/1/2024

Program: Renal Dialysis

On November 1, 2024, CMS released a fact sheet for the CY 2025 ESRD Final Rule.  This ESRD final rule provides updates to the ESRD Prospective Payment System, including the expanded coverage of home dialysis for beneficiaries with AKI, the ESRD Quality Incentive Program, and the ESRD Treatment Choices Model. The fact sheet, as well as a link to the final rule in the federal register, can be accessed here.

State: All

Date Posted : 11/1/2024

Program: Home Health

On November 1, 2024, CMS released a fact sheet for the CY 2025 Home Health Final Rule.  This Home Health final rule provides updates to the HH Prospective Payment System, HH Conditions of Participation, HH Quality Reporting Program, HH Value-Based Purchasing Model, and IVIG payment rates, as well as an update in Medicare Provider Enrollment expanding a Provisional Period of Enhanced Oversight to include providers and supplier reactivating their Medicare billing privileges.  The fact sheet, as well as a link to the final rule in the federal register, can be accessed here.

State: All

Date Posted : 11/14/2024

Program: Home Health, Hospice

Medicare covers a wide range of home health and hospice services. During Home Care & Hospice Month, get familiar with these Medicare Learning Network resources.

State: All

Date Posted : 11/4/2024

Program: Home Infusion Therapy, Pharmacy

Home infusion therapy involves the intravenous or subcutaneous administration of drugs or biologicals to an individual at home. The Geographic Adjustment Factors (GAFs) standardization factors, which are calculated to ensure that GAF updates are implemented in a budget neutral manner, are displayed on the CMS website. The CY 2024 national and geographically adjusted HIT payment rates were updated to reflect the changes to the GAF standardization factor.

State: Alabama

Date Proposed : 08/30/2024

Date Effective : 09/1/2024

Date Adopted : 10/21/2024

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

This regulation provides guidance on the requirement of a sales tax certificate of exemption related to durable medical equipment purchases beginning September 1, 2024. Effective August 1, 2014, any item used for the treatment of illness or injury or to replace all or part of a limb or internal body part purchased by or on behalf of an individual pursuant to a valid prescription and covered by and billed to Medicare, Medicaid, or a health benefit plan shall be exempt from state, county, and municipal sales, use, rental and leasing taxes. Effective September 1, 2024, any healthcare provider claiming an exemption shall obtain and maintain a certificate of exemption from the department in accordance with the provisions of Section 40-9-60, prior to the purchase and shall provide the certificate to the seller at the time of purchase. Any purchase made on or after September 1, 2024, shall be subject to tax, unless the healthcare provider provides the certificate to the seller at the time of purchase.  

State: California

Date Adopted : 09/30/2024

Program: Hospice

On September 30, 2024, California Assembly Bill 177 was chaptered.  This bill extends the deadline, from January 1, 2025, to January 1, 2026, for the Department to adopt emergency regulations related to Hospice.  This extension also extends the Hospice licensure moratorium until January 1, 2027, or one year after the date the emergency regulations are adopted.  The emergency regulations the Department are to implement include establishing requirements for office space, staffing ratios, management personnel, and geographical service areas.