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Long Awaited Approval of the 1115 Waiver Amendment for NYS Medicaid – Just in Time for the New York State Executive Budget State Fiscal Year (SFY) 2025

Health Care Law Brief

While still subject to legislative approval, the Executive Budget incorporates the recently approved amendment (“Waiver Amendment”) to New York’s Medicaid Section 1115 Demonstration that includes $7.5 billion in Medicaid investments over the next three years. Services will be delivered via a two-tiered system.

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CMS Imposes New Requirements on Payers to Improve Prior Authorization Process and Payer, Patient and Provider Communications

Hall Render

The Final Rule also imposes additional reporting requirements under the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals and for eligible clinicians reporting under the Promoting Interoperability performance category of the Merit-Based Incentive Payment System.

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CMS Finalizes its Proposal to Advance Interoperability and Improve Prior Authorization Processes

Healthcare Law Blog

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

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CMS Begins Option to Extend Medicaid Postpartum Coverage

Healthcare Law Blog

On April 1, 2022 , the Centers for Medicare & Medicaid Services (“CMS”) announced states may seek to extend Medicaid postpartum coverage from 60 days to one year through a new state plan option offered by the American Rescue Plan Act (“ARPA”). This option is available for five years and ends on March 31, 2027.

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Wasted: $1 of Every $4 Spent on Health Care In America

Health Populi

The Centers for Medicare and Medicaid Services (CMS) forecasts that prescription drug spending will be the fastest-growing cause of rising health spending by 2027. That’s the Holy Grail and vision in my book, HealthConsuming: From Health Consumer to Health Citizen. Political debates in this 2020 U.S.

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Health Provider News

Hall Render

Ransomware attacks against hospitals put patients’ lives at risk, researchers say States, FTC continue to target noncompetes: 3 updates The best hospital in each state, per Newsweek What to know about Stark law’s $9.2M

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National Health Spending Will Reach Nearly 20% of U.S. GDP By 2027

Health Populi

National health spending in the U.S. every year from 2020 to 2027, the actuaries at the Centers for Medicare and Medicaid Services forecast in their report, National Health Expenditure Projections, 2018-2927: Economic And Demographic Trends Drive Spending And Enrollment Growth , published yesterday by Health Affairs.