On May 22, 2025, the Centers for Medicare & Medicaid Services (CMS) announced updated guidance (“guidance”) concerning the Hospital Price Transparency Rule, which requires hospitals operating in the U.S. to publish a list of standard charges for items and services… Read More ›
The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule that would significantly enhance regulations around how Medicare Advantage (MA) organizations use internal coverage criteria, particularly relating to prior authorization and utilization management. The proposed changes, part… Read More ›
According to the Centers for Medicare & Medicaid Services (CMS), the Medicare Advantage program has now exceeded 50% of Medicare enrollments and in order to further increase transparency and strengthen programmatic data, on January 25, 2024, the agency issued a… Read More ›
On June 24th, 2019, then President Donald Trump issued an executive order titled “Improving Price and Quality Transparency in American Healthcare to Put Patients First”, instructing the Department of Health and Human Services (HHS) to propose a rule requiring “hospitals… Read More ›
On February 28th, 2022, as part of the State of the Union Address, the Biden administration released a fact sheet outlining its goals for increasing nursing home safety and transparency. The Biden Administration stated that these reforms “will improve the… Read More ›
According to a Centers for Medicare and Medicaid Services (CMS) statement, under the Biden executive order known as the “Inflation Reduction Act”, CMS has created the Medicare Drug Negotiation Program (MDNP), where Medicare will for the first time be able… Read More ›
The Healthcare Accountability and Consumer Protection Act (HACPA) enacted on June 23, 2023 amends the New York City Charter to establish an Office of Healthcare Accountability (OHA), headed by a Director of Healthcare Accountability (DHA). According to HACPA primary sponsor… Read More ›