Remove agencies centers-for-medicare-medicaid-services
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CMS Fact Sheet Addresses End of COVID-19 Public Health Emergency

ThomsonReuters

27, 2023) Available at [link] HHS’s Center for Medicare & Medicaid Services (CMS) has issued a fact sheet addressing the end of the COVID-19 public health emergency (PHE), which (along with the COVID-19 national emergency) is anticipated to end on May 11, 2023 (see our Checkpoint article ).

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HHS Resumes Processing Some Surprise Medical Billing IDR Payment Determinations

ThomsonReuters

Earlier this month, HHS’s Centers for Medicare & Medicaid Services (CMS) directed certified IDR entities not to issue new payment determinations until the agencies provide further guidance (see our Checkpoint article ). 3 (“Surprise Medical Billing: Emergency and Non-Emergency Services.”

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HHS Suspends Surprise Medical Billing IDR Payment Determinations

ThomsonReuters

CMS explains that the agencies are in the process of evaluating and updating the federal IDR process guidance, systems, and related documents to make them consistent with the court order but provides no timeline for the updated guidance. 3 (“Surprise Medical Billing: Emergency and Non-Emergency Services”).

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DOL Reports 2021 Mental Health Parity Enforcement Activity

ThomsonReuters

The DOL has issued a fact sheet summarizing 2021 mental health parity enforcement activity conducted by the DOL and the Centers for Medicare & Medicaid Services (CMS). If that fails, the agency may open a formal investigation involving the plan and its service providers. Fact Sheet.

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DOL Reports 2020 Mental Health Parity Enforcement Activity

ThomsonReuters

The DOL has issued a fact sheet summarizing 2020 mental health parity enforcement activity conducted by the DOL and (with respect to non-federal governmental group health plans) the Centers for Medicare & Medicaid Services (CMS). Here are highlights: Investigation Process. Enforcement Actions.

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Davis Polk Discusses FTC and DOJ Focus on Private Equity Investment in Healthcare

Reynolds Holding

Department of Health and Human Services announced that they are seeking public comment on private equity investment in the healthcare sector. Both initiatives sharply criticize private equity investment in healthcare providers, facilities and other ancillary products or services. The agencies remain bound by existing law and precedent.

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Health Plans Must Cover OTC COVID-19 Tests

ThomsonReuters

The agencies previously addressed the diagnostic testing requirements in FAQs Part 42 (see our Checkpoint article ), Part 43 (see our Checkpoint article ), and Part 44 (see our Checkpoint article ). In lieu of direct coverage, however, participants may be required to submit claims under the plan’s or insurer’s claims procedures.

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