Updates & Analysis

In this update:  Federal Agencies CMS Releases First No Surprises Act AuditOn July 15th, the Centers for Medicare & Medicaid Services (CMS) released its first audit of billing practices under the No Surprises Act. The audit reviewed air ambulance claims to Aetna Health of Texas from January to June 2022. It found that Aetna failed…

In this update:  NYS and NYC Opportunities DOH Announces Second Cycle of Nurses Across New York Loan Repayment ProgramOn July 10th, the New York State (NYS) Department of Health (DOH) issued a Solicitation of interest (SOI) for the second cycle of the Nurses Across New York Loan Repayment Program. This program makes funds available to…

In this update:  Federal Agencies CMS Releases Medicare Physician Fee Schedule Proposed Rule On July 10th, the Centers for Medicare and Medicaid Services (CMS) released the Calendar Year (CY) 2025 Medicare Physician Fee Schedule (PFS) proposed rule. As required by current statute, the 2025 PFS would reduce average payment rates by 2.93% relative to CY 2024.…

In this update:  NYS and NYC Opportunities OMH Releases Tentative Schedule of Upcoming Funding OpportunitiesAs part of the New York State (NYS) Fiscal Year 2023-2024 budget, Governor Hochul initiated a multi-year plan to transform the continuum of mental health care. To assist with this plan and to help providers prepare for upcoming funding opportunities, the…

In this update:  Federal Opportunities HRSA Issues FY 2025 FQHC Service AreaCompetitionOn June 27th, the Health Resources and Services Administration (HRSA) posted a new Service Area Competition (SAC) opportunity for FY 2025. Through the SAC, organizations may apply to participate in the federally qualified health center (FQHC) program by taking over a grant in an existing…

In this update: Legislative Update Legislators Send Letter to CMS on Use of AI in Medicare AdvantageOn June 25th, a bipartisan group of legislators from both the House and Senate sent a letter urging the Centers for Medicare and Medicaid (CMS) to increase oversight of artificial intelligence (AI) and other algorithmic software tools in Medicare…

In this update:  Legislative Update House E&C Committee Issues RFI on Cures 2.0On June 6th, the House Energy & Commerce (E&C) Committee issued a Request for Information (RFI) on potential policies to include in proposed Cures 2.0 legislation. The original 21st Century Cures Act, enacted eight years ago, is widely regarded as a landmark reform to…

In this update:  NYS and NYC Opportunities DOH Issues RFP for Statewide Fiscal Intermediary Services On June 17th, the New York State (NYS) Department of Health (DOH) issued a Request for Proposals (RFP) seeking one qualified organization for the provision of Statewide Fiscal Intermediary (FI) services. As per the 2024-25 Enacted NYS Budget, the State intends…

In this update:  Legislative Updates Democratic Senators Send Letter to HHS on Mental Health Parity On June 6th, Senator Chris Murphy (D-CT) led a group of seven Democratic senators in writing to the Department of Health and Human Services (HHS), the Department of Labor (DoL), and the Internal Revenue Service (IRS) urging them to finalize proposed…

In this update:  Federal Opportunities HRSA Issues NOFO for Grants to Fund New FQHC SitesOn May 30th, the federal Health Resources & Services Administration (HRSA) issued the New Access Points Notice of Funding Opportunity (NOFO) for new sites under the Federally Qualified Health Center (FQHC) Program. This is the first such NOFO issued since 2019,…

In this update:  Federal Agencies CMMI Releases RFA for Enhancing Oncology Model On May 30th, the Center for Medicare and Medicaid Innovation (CMMI) released a Request for Applications (RFA) for the second cohort of the Enhancing Oncology Model (EOM). The intent of the EOM is to reduce program spending while preserving or enhancing the quality of…

In this update: Legislative Update Senator Wyden Sends Letter to CMS on Fraudulent ACA EnrollmentsOn May 21st, Senate Finance Committee Chair Ron Wyden (D-OR) sent a letter to the Centers for Medicare and Medicaid Services (CMS) urging the agency to enforce civil monetary penalties on health insurance brokers who fraudulently change enrollees’ health plans. Recently,…