Proposed CY 2022 HOPPS/ASC Rules

Aug 3, 2021 | ASC, Hospitals, Outpatient

HOPPS/ASC: For 2022, CMS has proposed a +2.3% rate update to the hospital outpatient prospective payment system (HOPPS) and the ambulatory surgical center (ASC) payment system. Click to read more. You can also view our July Monthly Snapshot here.

Proposed CY 2022 Physician Fee Schedule

Aug 3, 2021 | Physician Fee Schedule

Physician Fee Schedule (PFS): CMS has published the proposed PFS Rule for CY 2022.  After accepting public comment on the rule, CMS will publish a final rule around November 1, 2021 with an effective date of January 1, 2022. Click to read more. Join BRG expert John Kelliher to discuss the 2022 PFS proposed rule on Friday, August 6th at 1PM EST. Please register here in advance of the call. Following registration, you will receive a confirmation email with dial-in information.

Managed Care Friday

Jul 30, 2021 | Managed Care Friday

$140M: The amount Anthem and Humana are investing in a new pharmacy benefit manager. With this investment, the plans will hold a minority stake in the new company, DomaniRx. SS&C Technologies, a fintech company, will own the other 80%. Humana will be the PBM’s first customer, as the company “aims to offer payers more transparency into their drug costs and help them better comply with changing government regulations” according to a press release. Did You Hear About The Detox Fix? A noninvasive treatment to manage opioid withdrawal symptoms recently hit the market. S.T. Genesis looks like...

BRG Quarterly Compliance and Program Integrity Developments

Jul 29, 2021 | Legislation/ Budgets/ Macro, Revenue Cycle

The BRG Healthcare Transactions and Strategy quarterly compliance bulletin compiles noteworthy developments in the healthcare sector related to compliance, program integrity, and enforcement activities. In the second quarter of 2021, we have taken particular note of: DOJ/HHS activity OIG semiannual report Four Comparative Billing Reports Three GAO reports OCR activity Approved and proposed additions to the RAC audit list Click to read more.

Weekly Medicaid Update

Jul 28, 2021 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: AZ: State to allow certain parents to be paid by Medicaid as licensed nurse aides MI: State publishes new Medicaid ABA policy and proposed Home Help policy MO: Missouri Supreme Court rules in favor of Medicaid expansion PA: Proposal to increase minimum number of direct care hours per day for nursing home residents Click to read more.