Billy Wynne

Updates to the Master List Include Codes for Catheters, Ostomies, Collagen Dressings, Wound Covers, Infusion Pumps, and Wheelchairs, Among Other Items The Centers for Medicare and Medicaid Services (CMS) issued updates to the Master List of Items Potentially Subject to Face-To-Face Encounter and Written Order Prior to Delivery and/or Prior Authorization Requirements (Master List) and…

CMS Proposes New Model on Increasing Organ Transplant Access (IOTA) Today the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS) Innovation Center, announced the Increasing Organ Transplant Access (IOTA) Model (press release/ fact sheet/full proposal).  The IOTA Model aims to increase access to life-saving kidney transplants…

Senate Budget Committee Members Discuss Drivers of Administrative Burden in Health Care, Chair Advocates for Bipartisan Discussion Draft to Establish Hybrid Primary Care Payments in Medicare The Senate Budget Committee convened a hearing to examine ways to alleviate administrative burdens in health care. Democrats used the hearing to criticize prior authorization and emphasize the need…

Committee Leaders Release Competing Frameworks for Farm Bill Legislation As the deadline to reauthorize Farm Bill Programs by the end of the fiscal year approaches, policymakers in the committees of jurisdiction have begun to discuss legislative proposals. In addition to agricultural programs, the Farm Bill authorizes several important federal nutrition programs including the Supplemental Nutrition Assistance…

House Ways & Means Committee Plans Markup of Telehealth Legislation The House Ways & Means Committee is convening a markup Wednesday May 8th at 10:30am to discuss legislative proposals aimed at temporarily extending certain pandemic-era flexibilities, including those related to telehealth (through 2026) and the Acute Hospital Care at Home initiative (through 2029). The cost…

Medicare Trustees Now Predict Medicare Insolvency in 2036, Five Years Later Than Last Year’s Prediction  Today, the Medicare Trustees released their latest report on the status of the Hospital Insurance (HI) and Supplemental Medicare Insurance (SMI) trust funds (fact sheet; press release). The Trustees release this report annually to provide an update on the projected…

Agency Releases Legal Sidebar Analyzing the Scope of ACA Section 1557 The Congressional Research Service (CRS) released a Legal Sidebar analyzing the implications of the Department of Health and Human Services’ (HHS) finalization of a new rule under Section 1557 of the Patient Protection and Affordable Care Act (ACA) (Impact Health summary of the final…

Departments Extend Qualifying Payment Amount Enforcement Discretion Until November 1, 2024 The Departments of Health and Human Services, Labor, and Treasury (the Departments) released Frequently Asked Questions (FAQs) Part 67 to extend the qualifying payment amount (QPA) enforcement discretion under the No Surprises Act until November 1, 2024. Background. In August 2023, the U.S. District Court…

Agency Expands Marketplace and BHP Health Coverage to DACA Recipients; Does Not Update Definition of “Lawfully Present” for Medicaid and CHIP The Centers for Medicare and Medicaid Services (CMS) released a final rule to revise the definition of “lawfully present” in order to expand eligibility for health insurance coverage through the Exchange and Basic Health…

UnitedHealth Group CEO Faces Bipartisan Scrutiny Regarding Change Healthcare Cyberattack; Legislators Push for Minimum Cybersecurity Standards The Senate Finance Committee and the House Energy and Commerce (E&C) Oversight and Investigations Subcommittee held hearings focused on the cyberattack that targeted Change Healthcare, a subsidiary of UnitedHealth Group (UHG), leading to widespread disruptions in the health care…