Industry news

New CMS Regulation Establishes Maximum Appointment Wait Time Standards for Medicaid

Learn about CMS' new compliance obligations for managed care plans, including a provision that expands network adequacy requirements to create appointment wait time standards.

Interoperability

2021 Office Visit Documentation Reforms Create Opportunities for New AI Documentation Solutions

As physicians continue to struggle with regulatory and administrative burdens, it’s exciting to see the advent of new AI-enabled ambient listening solutions* that can reduce the time physicians have to spend documenting and/or dictating notes. This is especially true when considered in the context of the landmark 2021 office visit documentation and coding system overhaul.

Industry news

Top 5 Takeaways from CMS’s New 2024 Medicare Physician Payment Rule

Every year, industry stakeholders anticipate the release of the annual CMS regulation because it updates the rules governing Medicare’s value-based programs.

Telehealth

5 Key Takeaways from Medicare’s New 1,300 Page Physician Payment Regulation

On August 3, the Centers for Medicare & Medicaid Services (CMS) released its proposed 2021 Medicare Physician Fee Schedule rule. The 1,353-page rule proposes updates that would take effect on January 1, 2021 for Medicare’s physician payment system, Quality Payment Program, Shared Savings Accountable Care Organization (ACO) program, telehealth services program, and more. This year’s rule was highly anticipated by industry stakeholders because it includes important COVID-19 updates impacting both the current public health emergency and the permanent Medicare program.

NextGen Advisors

Are Big Changes Coming for Value-based Payment Models?

In September, CMS finalized a new mandatory value-based payment model for patients with kidney disease and a new mandatory value-based payment model for cancer patients receiving radiotherapy treatment. Rather than voluntary models that offer healthcare providers the option to participate, these models require mandatory participation for a select group of providers.

COVID-19

CARES Act Programs Begin Paying Out Billions in Aid to Physicians

On Friday, April 10, the U.S. Department of Health and Human Services (HHS) announced that it would immediately begin paying out $30 billion in relief funds to Medicare-enrolled healthcare providers across the country.

COVID-19

CMS Reaffirms Commitment to Value-based Payment Models by Adding COVID-19 Flexibilities

Prior to the COVID-19 pandemic, the transition to value-based reimbursement via alternative payment models (APMs) was a top priority of the U.S. Department of Health and Human Services (HHS) and its Centers for Medicare and Medicaid Services (CMS).

COVID-19

CMS Increases Payment for Phone Visits, First Insurer Makes COVID-19 Telehealth Changes Permanent 

As physicians and patients continue to turn towards virtual visits during the COVID-19 pandemic, both the Centers for Medicare and Medicaid Services (CMS) and commercial payers continue to tweak their telehealth regulations and policies to support this transition.

COVID-19

CMS Offers ACOs Regulatory Relief in Response to the COVID-19 Pandemic

On April 30, the Centers for Medicare and Medicaid Services (CMS) released a 279-page interim final rule that makes several important regulatory changes in response to the COVID-19 emergency.

Telehealth

CMS Moving Forward with Major Physician Office Visit Reforms in 2021

In a recent blog post, we offered five key takeaways from the Centers for Medicare & Medicaid Services’ (CMS’s) new 1,300-page proposed 2021 Medicare physician payment rule. Since the release of that rule a few weeks ago, much of our industry’s attention has been focused on the telehealth policy proposals, and more specifically, on which COVID-19 emergency telehealth policies CMS plans to make permanent after the emergency ends.

COVID-19

Congress passes $2.2 trillion coronavirus relief bill

Wednesday evening the U.S. Senate passed its coronavirus economic relief bill with a unanimous vote of 96-0.

Telehealth

Congress Working to Avoid a Pre-election Shutdown and Pass More COVID-19 Aid

Today, lawmakers return to Washington, D.C. with only 50 days remaining until election day on November 3. Aside from engaging in a heavy dose of election-year politics, members of Congress should be busy trying to pass two major pieces of legislation in the coming weeks.

NextGen Advisors

Congress Unlikely to Pass Coronavirus Relief Bill Pre-Election

Last month, Congress returned to Washington, D.C. from its August recess with the hopes of quickly passing key government funding and coronavirus relief bills prior to any October electoral surprises.

NextGen Advisors

Community Health Center COVID-19 Vaccine Program Starts this Week

This week, the federal government will begin allocating COVID-19 vaccines directly to select Federally Qualified Health Centers (FQHCs) across the country. The move follows an official announcement last week from President Biden and members of his COVID-19 response task force.

COVID-19

Medicare Expands Telehealth Services to Community Health Centers Under CARES Act

As required by the Coronavirus Aid, Relief, and Economic Security (CARES) Act, on April 17, 2020, the Centers for Medicare and Medicaid Services (CMS) issued new guidance authorizing community health centers to furnish telehealth services to Medicare beneficiaries during the COVID-19 pandemic.

COVID-19

New Forgivable SBA Loan Program Launches Today and Many Physician Practices are Likely Eligible

Through a mix of increased reimbursements, advanced payments, targeted grants, and a U.S. Department of Health and Human Services (HHS) emergency fund, the new Coronavirus Aid, Relief, and Economic Security (CARES) Act provides $150 billion of financial assistance for the healthcare sector.

COVID-19

HHS's New Reimbursement Program for Uninsured COVID-19 Patients

As a result of the March 2020 CARES Act and the Provider Relief Fund it established, in April the U.S. Department of Health and Human Services (HHS) announced the launch of a new program to provide claims reimbursement to healthcare providers for testing uninsured individuals for COVID-19 and treating uninsured individuals with a COVID-19 diagnosis.

NextGen Advisors

Elective Surgery Set to Resume in States Across the Country

In welcome news for many physicians and patients, states all across the country are announcing plans to resume elective surgeries and procedures.

NextGen Advisors

Congress Considers the Future of Telehealth

The rapid expansion in telehealth services was driven both by the necessity of virtual care during the pandemic and by the temporary relaxing of decades-old regulations. For Congress, the job now is to determine what telehealth laws should look like after the pandemic ends and the temporary waivers subside.

COVID-19

Top Regulatory Issues Physicians Should Watch Out for Next Year

In this blog, Chris Emper describes challenges and regulatory changes physicians should expect in 2022.

COVID-19

5 Key Takeaways from 2021 Medicare Physician Fee Schedule Rule

This blog includes five key takeaways from the Medicare’s new 1,300+ page proposed rule that could have a major impact on physician groups.

COVID-19

5 Key Takeaways from 2021 Medicare Physician Fee Schedule Rule

This blog includes five key takeaways from the Medicare’s new 1,300+ page proposed rule that could have a major impact on physician groups.

NextGen Advisors

2020 Mid-Year Regulatory Update: Key Issues to Watch

With the healthcare industry at the center of many of these changes, tracking new regulations has never been more important for physician practices. As we look ahead to the second half of the year with CMS’s annual rulemaking cycle and the 2020 elections still to come, there are no signs of the pace of change slowing down.

NextGen Advisors

2020 Mid-Year Regulatory Update: Key Issues to Watch

With the healthcare industry at the center of many of these changes, tracking new regulations has never been more important for physician practices. As we look ahead to the second half of the year with CMS’s annual rulemaking cycle and the 2020 elections still to come, there are no signs of the pace of change slowing down.

NextGen Advisors

What ACOs can expect from the Biden Administration

Much of the healthcare industry's attention during the first few months of Joe Biden's Presidency has rightfully been focused on how his Administration and the new Democratic-led Congress have responded to the COVID-19 pandemic. Naturally, this has somewhat limited the focus on other key issues, including the future of value-based care and alternative payment models.

NextGen Advisors

What ACOs can expect from the Biden Administration

Much of the healthcare industry's attention during the first few months of Joe Biden's Presidency has rightfully been focused on how his Administration and the new Democratic-led Congress have responded to the COVID-19 pandemic. Naturally, this has somewhat limited the focus on other key issues, including the future of value-based care and alternative payment models.

NextGen Advisors

CMS Creates New Office Focused on Reducing Provider Burden

While it remains unclear what impact the creation of this new office will have, it clearly signals that reducing provider burden is one of agency’s top policy and political priorities.

NextGen Advisors

CMS Releases Proposed 2022 Medicare Physician Payment Policies

On July 13, the Centers for Medicare & Medicaid Services (CMS) released its annual rule proposing updates to its payment system for physicians in Medicare. NextGen Advisor Chris Emper reviews some of the key elements and proposals.

Small Practice

My Top Takeaways from Medicare's New Physician Payment Rules

In this blog post, Chris Emper, Government Affairs Advisor, discusses new regulations issued by the CMS that will impact our country's seniors in 2020.

Population Health

Congress tackles the opioid crisis

A breakdown of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act.

Industry news

DEA extends pandemic-era telehealth rules for prescribing controlled medications

The DEA extends temporary pandemic-era telehealth rules for prescribing controlled medications that is planned to turn into a permanent rule later this year.

Interoperability

Digital Health Regulatory Issues to Watch in 2020

From the widespread adoption of electronic health records (EHRs), to the advances (and failures) of patient data interoperability, to the launch of the health app economy through application programming interfaces (APIs), the digital health industry over the past decade has grown and evolved significantly as a direct result of government regulations. And now, as we enter 2020, there are a handful of emerging regulatory issues that have the potential to play a major role in shaping the future direction of our industry over this next decade.

Interoperability

Digital Health Regulatory Issues to Watch in 2020

From the widespread adoption of electronic health records (EHRs), to the advances (and failures) of patient data interoperability, to the launch of the health app economy through application programming interfaces (APIs), the digital health industry over the past decade has grown and evolved significantly as a direct result of government regulations. And now, as we enter 2020, there are a handful of emerging regulatory issues that have the potential to play a major role in shaping the future direction of our industry over this next decade.

Industry news

21st Century Cures Act: Five Years Later

Following NextGen Healthcare's Cures Act certification last month, our legislative expert, Chris Emper, presents a detailed overview of how this monumental law will impact key IT interoperability provisions going forward.

Industry news

21st Century Cures Act: Five Years Later

Following NextGen Healthcare's Cures Act certification last month, our legislative expert, Chris Emper, presents a detailed overview of how this monumental law will impact key IT interoperability provisions going forward.

NextGen Advisors

HHS Awards Record $3 Billion to Behavioral Health Grant Programs

The U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) announced that it was distributing $3 billion in block grant funds authorized by the American Rescue Plan Act.

NextGen Advisors

The Physician’s Guide to HHS’s New Surprise Billing Rules

In this blog, our legislative expert, Chris Emper, lays out a rule-by-rule manual for navigating the new surprise billing regulations.

NextGen Advisors

The Physician’s Guide to HHS’s New Surprise Billing Rules

In this blog, our legislative expert, Chris Emper, lays out a rule-by-rule manual for navigating the new surprise billing regulations.

COVID-19

Medicare Expands Telehealth Benefits During COVID-19 Emergency

In response to the COVID-19 outbreak, the federal government has acted to expand telehealth coverage for Medicare beneficiaries.

COVID-19

Medicare Expands Telehealth Benefits During COVID-19 Emergency

In response to the COVID-19 outbreak, the federal government has acted to expand telehealth coverage for Medicare beneficiaries.

Industry news

The House passed its Obamacare repeal bill, so what happens next?

Last week House Republicans passed their bill to repeal and replace key elements of Obamacare. Here's the update.

NextGen Advisors

2100 Pages for 2021: Key Takeaways from CMS's New Physician Payment Rules

On December 1, the Centers for Medicare & Medicaid Services (CMS) officially released its annual Physician Fee Schedule (PFS) final rule for 2021. The rule updates payment policies and quality programs under Medicare’s Physician Fee Schedule (PFS) starting January 1, 2021.

NextGen Advisors

2100 Pages for 2021: Key Takeaways from CMS's New Physician Payment Rules

On December 1, the Centers for Medicare & Medicaid Services (CMS) officially released its annual Physician Fee Schedule (PFS) final rule for 2021. The rule updates payment policies and quality programs under Medicare’s Physician Fee Schedule (PFS) starting January 1, 2021.

Value-based Care

MACRA and value-based reimbursement: Full steam ahead

MACRA represents significant progress toward value-based reimbursement and sets a framework for shifting physician payments for Medicare away from fee-for-service.

Industry news

What You Need to Know about CMS’s 2023 Proposed Medicare Physician Payment Rule

The Centers for Medicare & Medicaid Services (CMS) just released its proposed—and much-awaited—payment schedule for providers. NextGen Advisor Chris Emper breaks down the key takeaways.

Industry news

What Physicians Need to Know About the New Federal Budget Agreement

Understand the healthcare policy changes physicians need to know made by the federal budget agreement, the Bipartisan Budget Act of 2018.

NextGen Advisors

President Biden's Healthcare Policy Agenda

This week, as Joe Biden takes the oath of office to become the 46th President of the United States, many in the healthcare industry are wondering what impact the new President will have on the pandemic and broader healthcare reform initiatives.

NextGen Advisors

President Biden's Healthcare Policy Agenda

This week, as Joe Biden takes the oath of office to become the 46th President of the United States, many in the healthcare industry are wondering what impact the new President will have on the pandemic and broader healthcare reform initiatives.

NextGen Advisors

Community Health Centers Awarded Record $6.1 Billion in Federal Grant Funding

The HHS’s Health Resources & Services Administration will award billions in grants to federally qualified community health centers.

NextGen Advisors

Community Health Centers Awarded Record $6.1 Billion in Federal Grant Funding

The HHS’s Health Resources & Services Administration will award billions in grants to federally qualified community health centers.

Industry news

Simplifying healthcare reform: The known and the unknown

How quickly will any changes stemming from the ACA repeal start taking place? Where is the industry headed in terms of payment reform? We answer your questions.

Value-based Care

10 things to know about MACRA for 2018

Government affairs expert for NextGen gives us the rundown of what's new for MACRA this year.

Industry news

5 Takeaways from GOP's Obamacare Repeal and Replace Bill

NextGen Government Affairs expert Chris Emper gives us his initial thoughts on the plan to repeal and replace Obama's "American Healthcare Act" (ACA).

Population Health

The Trump Administration’s 2018 Healthcare Reboot

2017 was a year of tremendous uncertainty for healthcare providers. After spending the previous several years adjusting to the realities of and complying with The Affordable Care Act (aka the ACA), the provider community watched President Trump take office last January and install Tom Price as Secretary of the U.S. Department of Health and Human Services (HHS) with a promise to aggressively pursue the repeal of major elements of the law.

Industry news

What Physicians Need to Know about the New Medicare Payment Rules

Chris Emper, Government Affairs Advisor, provides his top takeaways from the proposed updates to the rules governing both the MACRA and QPP.

Interoperability

What You Need to Know about the New Health Data Interoperability Regulations

On March 9, the U.S. Department of Health and Human Services (HHS) released two long-awaited health data interoperability regulations.

Industry news

HHS Begins Enforcement of Information Blocking Rules for Healthcare Providers

Discover how the 21st Century Cures Act enforces information blocking rules and the resulting penalties for healthcare providers.