Newsletters

10.30.24

Humana Becomes Fourth Plan to Challenge Medicare Advantage Star Ratings

On October 18, Humana <a href="https://www.documentcloud.org/documents/25244688-humana_hhs_stars_complaint">filed</a> suit against CMS challenging the 2025 MA Star Ratings assigned to its plans.


09.09.24

HIPAA Reproductive Privacy Protections at Risk By Texas Lawsuit

Last week, Texas AG Ken Paxton (R) sued the Department of Health and Human Services (HHS), alleging that the new HHS final rule amending HIPAA regulations to strengthen protections for reproductive health information is unlawful and should be vacated (e.g., not go into effect).


08.22.24

CMS Opens Funding Opportunity for States to Participate in Cell and Gene Therapy Model

On August 15, the Centers for Medicare & Medicaid Services (CMS) released a Notice of Funding Opportunity (NOFO) for states participating in the Cell and Gene Therapy (CGT) Access Model.


08.22.24

The Inflation Reduction Act Infographic: Overview of Announced Drug Prices

On August 15, 2024, the Centers for Medicare & Medicaid Services (CMS) announced the “maximum fair prices (MFPs)” for the first 10 drugs subject to the Medicare drug negotiation program. 


06.26.24

CMS and ONC Issue Final Rule on E-Prescribing

On June 17, CMS and the Office of the National Coordinator for Health Information Technology (ONC) issued a final rule implementing new standards for e-prescribing under Medicare Part D.


05.22.24

Marketing Organizations File Suit Over Medicare Advantage Final Rule

On May 13, an association of Medicare Advantage field marketing organizations (FMOs) filed suit against CMS, challenging new marketing restrictions in the 2025 Medicare Advantage final rule.


05.22.24

CMS Issues Update on Stacking Provision in Medicaid Drug Rebate Program Rule

On May 15, the Centers for Medicare & Medicaid Services (CMS) issued a statement saying that it would not finalize the “stacking” proposal in its Medicaid Drug Rebate Program proposed rule—the remaining provisions are expected to be finalized soon. 


02.13.24

Changes to the Substance Use Disorder Confidentiality Regulation: Implications for Stakeholders

Last week, the Department of Health and Human Services (HHS) released a final rule intended to implement a 2020 modification to the federal substance use disorder (SUD) privacy statute.


01.30.24

CMS Final Rule Requires Payers to Modify Prior Authorization, Create New APIs

In the federal government’s latest effort to promote interoperability in the health care sector, on January 17 the Centers for Medicare & Medicaid Services (CMS) released a final rule that expands the requirements for electronic exchange of information between federally funded health ...


12.14.23

HHS Finalizes Regulation of Certain AI

This week, the U.S. Department of Health and Human Services (HHS) took its first step in actually regulating the use of artificial intelligence (AI) in health care.