Regulatory Updates

Massachusetts – Guidance for healthcare personnel (HCP) in health care settings with respiratory virus infection or exposure.
ACHC Published: September 3, 2025
Date Effective: 09/01/2025

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

Guidance

State: Massachusetts

Dear Health Care Colleagues-

As we plan for the upcoming respiratory virus season, the Massachusetts Department of Public Health is reaching out to share updated guidance for healthcare personnel (HCP) in health care settings with respiratory virus infection or exposure. Over the past few months several states in the northeast region have been collaborating on important infection prevention and control issues.  We worked together to develop consensus guidance based on evidence presented by Healthcare Infection Control Practices Advisory Committee (HICPAC) at an advisory meeting in November 2024.  Please review the attached document and update your policies as appropriate.

Thank you for your ongoing support of your patients, staff and communities,

The Massachusetts Department of Public Health

Florida – All Provider Types UPDATE: Hurricane Debby – Key Medicaid Information for Fee-for-Service and Managed Care Providers
ACHC Published: April 21, 2025
Date Adopted: 08/1/2024
Date Expired: 09/3/2024

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

Adopted

State: Florida

The purpose of this alert is to provide an update to the previous provider alert issued on 08/04/2024 regarding Hurricane Debby.

The following flexibilities/waivers offered to providers in the alert issued on 08/04/2024 will expire at 11:59 p.m. on Tuesday, September 3, 2024:

  • Waiver of prior authorization requirements for critical Medicaid services
    • The lifting of early prescription refill edits will remain in place in accordance with Governor Ron DeSantis’ emergency executive orders issued for Hurricane Debby
  • Waiver of service limitations to ensure a recipient requiring critical Medicaid services during the storm receives such care
  • Temporary postponement of the Preadmission Screening and Resident Review processes

Additional questions from providers may be directed to the Florida Medicaid Contact Center at 1- 877-254-1055

mln Booklet Updated: Items & Services Not Covered Under Medicare
ACHC Published: September 5, 2024
Date Posted (CMS): 09/5/2024

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Critical Care Hospital, Durable Medical Equipment and Supplies

CMS

State: All

This booklet outlines items and services Medicare never or only sometimes covers. This isn’t an all-inclusive list. For Medicare Advantage (MA) plan patients, check with the MA plan for information on eligibility, coverage, and payment. Each plan can have different patient out-of-pocket costs and specific rules for getting and billing for services. Follow the plan’s terms and conditions for payment.

Note: Any item or service provided directly or indirectly by an individual or entity excluded by the Office of Inspector General from all federal health care programs isn’t covered.

CMS 2025 Proposed Rule for Hospitals and Ambulatory Surgical Centers
ACHC Published: July 21, 2024
Date Posted (CMS): 07/19/2024

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

CMS

State: All

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.

Florida Providers – Licensure Renewal Application Process Revised
ACHC Published: March 5, 2024
Date Effective: 03/5/2024

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Assisted Living, Behavioral Health, Clinical Laboratory, Home Care, Home Health, Home Infusion Therapy, Hospice

State: Florida

Pursuant to Florida Rule 59A-35.060, effective March 5, 2024, all providers will be required to submit renewal applications through AHCA’s online licensing system.

Provider and Supplier Compliance Education Through Quality in Focus
ACHC Published: May 7, 2023
Date Posted (CMS): 01/19/2023

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Critical Care Hospital, Home Health, Hospice, Renal Dialysis

CMS

State: All

Quality in Focus: CMS developed a series of short (10–15 minutes), Quality in Focus interactive videos tailored for specific provider types. The series aims to increase the quality of care for people with Medicare and Medicaid by reducing the deficiencies most commonly cited during the CMS survey process, such as infection control and accident prevention.

Medicare Enrollment in PECOS: Faster & Easier Application Process
ACHC Published: January 26, 2023
Date Posted (CMS): 01/26/2023

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Critical Care Hospital, Durable Medical Equipment and Supplies, Orthotics, Prosthetics

CMS

State: All

Medicare Enrollment in PECOS: Faster & Easier Application Process — Coming Summer 2023

Submitting and tracking Medicare Enrollment applications in PECOS is about to get easier and faster. Starting this summer, PECOS will have features to better meet your needs. Watch this 2-minute video or read these FAQs to learn more about:

  • A single application for multiple enrollments
  • Pre-population of data and an application that’s tailored to you
  • Enhanced capability to add or delete group members
  • Real-time processing checks and status updates
  • Re-validation reminders

The PECOS redesign will include a robust Knowledge Base with extensive content to help answer questions about enrollment, how to use all the new features, and much more.

We’ll provide you with regular updates on the PECOS redesign over the coming months.

No Surprises Act: Fact Sheets for Your Patients
ACHC Published: June 30, 2022
Date Posted (CMS): 07/1/2021

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Critical Care Hospital, Home Health, Home Infusion Therapy, Hospice, Renal Dialysis

CMS

State: All

Share information with your patients to help protect them from surprise billing. As of January 1, 2022, they have new billing protections when they get:

  • Emergency care
  • Non-emergency care from out-of-network providers at in-network facilities
  • Air ambulance services from out-of-network providers